Provider Demographics
NPI:1477274629
Name:CRUZ SANTIAGO, YARA T (MD)
Entity type:Individual
Prefix:
First Name:YARA
Middle Name:T
Last Name:CRUZ SANTIAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 5280
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9715
Mailing Address - Country:US
Mailing Address - Phone:787-930-3856
Mailing Address - Fax:
Practice Address - Street 1:BO. RIO CANAS ABAJO
Practice Address - Street 2:CALLE 3 #84
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-9715
Practice Address - Country:US
Practice Address - Phone:787-930-3856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22997208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice