Provider Demographics
NPI:1881622116
Name:ORTIZ-CRUZ, JOSE LUIS (MD)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LUIS
Last Name:ORTIZ-CRUZ
Suffix:
Gender:M
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:PO BOX 5094
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5094
Mailing Address - Country:US
Mailing Address - Phone:787-746-7480
Mailing Address - Fax:787-746-7480
Practice Address - Street 1:HOSPITAL GENERAL MENONITA, BO RINCON
Practice Address - Street 2:# 373130
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737-3130
Practice Address - Country:US
Practice Address - Phone:787-738-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8130207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
600302OtherMMM
067241OtherCRUZ AZUL
7250008OtherHUMANA
9490OtherIMC
29384OROtherSSS
600302OtherMMM
7250008OtherHUMANA