Provider Demographics
NPI:1770272916
Name:MUNIZ CRUZ, LUIS ENRIQUE
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ENRIQUE
Last Name:MUNIZ CRUZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 BO PALMAREJO
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2212
Mailing Address - Country:US
Mailing Address - Phone:787-904-7745
Mailing Address - Fax:
Practice Address - Street 1:627 BO PALMAREJO
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2212
Practice Address - Country:US
Practice Address - Phone:787-904-7745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR101374163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse