Provider Demographics
NPI:1104619162
Name:CRUZ SANTIAGO, MILIANETTE
Entity type:Individual
Prefix:
First Name:MILIANETTE
Middle Name:
Last Name:CRUZ SANTIAGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:T2 CALLE 19
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-4649
Mailing Address - Country:US
Mailing Address - Phone:787-672-2895
Mailing Address - Fax:
Practice Address - Street 1:6W9X PPR
Practice Address - Street 2:PR 52
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program