Provider Demographics
NPI:1952572067
Name:GOMEZ CRUZ, MICHELLE J (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:GOMEZ CRUZ
Suffix:
Gender:F
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 637
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-0637
Mailing Address - Country:US
Mailing Address - Phone:787-975-9458
Mailing Address - Fax:
Practice Address - Street 1:SAN JUAN CITY HOSPITAL
Practice Address - Street 2:PMB #498 70344
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-8344
Practice Address - Country:US
Practice Address - Phone:787-766-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR209582080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology