Provider Demographics
NPI:1457994675
Name:CRUZ VELEZ, MISAEL J (RN, BSN)
Entity Type:Individual
Prefix:
First Name:MISAEL
Middle Name:J
Last Name:CRUZ VELEZ
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A21 VILLA SERAL
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-3002
Mailing Address - Country:US
Mailing Address - Phone:939-244-8713
Mailing Address - Fax:
Practice Address - Street 1:A21 VILLA SERAL
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-3002
Practice Address - Country:US
Practice Address - Phone:939-244-8713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR78513163WC1500X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health