Provider Demographics
NPI:1780783704
Name:CRUZ, ELIZABETH TOLEDO (PH)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:TOLEDO
Last Name:CRUZ
Suffix:
Gender:F
Credentials:PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CALLE ANTILLA
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3215
Mailing Address - Country:US
Mailing Address - Phone:178-781-5576
Mailing Address - Fax:178-787-8206
Practice Address - Street 1:CARR 635 KM 0.1 BO DOMIGUITO SECTOR GREEN
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:178-787-8206
Practice Address - Fax:178-787-8206
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist