Provider Demographics
NPI:1144954777
Name:CRUZ RENTAS, PEDRO AUGUSTO (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:AUGUSTO
Last Name:CRUZ RENTAS
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:HC 6 BOX 6354
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9898
Mailing Address - Country:US
Mailing Address - Phone:939-314-0988
Mailing Address - Fax:
Practice Address - Street 1:URB,ATENAS CALLE HERNANDEZ CARRION
Practice Address - Street 2:CARR #2,INT 668
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24131208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice