Provider Demographics
NPI:1912431719
Name:CRUZ, BRENDA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 CALLE MARGINAL VILLAMAR
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-6346
Mailing Address - Country:US
Mailing Address - Phone:787-200-0380
Mailing Address - Fax:787-200-0389
Practice Address - Street 1:1035 CALLE MARGINAL VILLAMAR
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-6346
Practice Address - Country:US
Practice Address - Phone:787-200-0380
Practice Address - Fax:787-200-0389
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist