Provider Demographics
NPI:1750694485
Name:CRUZ, HECTOR RUBEN (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:RUBEN
Last Name:CRUZ
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE PONCE DE LEON
Mailing Address - Street 2:455
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00915-3959
Mailing Address - Country:US
Mailing Address - Phone:787-620-9610
Mailing Address - Fax:787-765-6768
Practice Address - Street 1:AVE PONCE DE LEON
Practice Address - Street 2:455
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00915-3959
Practice Address - Country:US
Practice Address - Phone:787-620-9610
Practice Address - Fax:787-765-6768
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist