Provider Demographics
NPI:1548314719
Name:CRUZ SOTO & PADILLA, NEFROLOGOS, CSP
Entity type:Organization
Organization Name:CRUZ SOTO & PADILLA, NEFROLOGOS, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADOR
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRUZ-SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-854-4120
Mailing Address - Street 1:PO BOX 1662
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1662
Mailing Address - Country:US
Mailing Address - Phone:787-854-4120
Mailing Address - Fax:787-884-5489
Practice Address - Street 1:URB ATENAS HERNANDEZ CARRION
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-4120
Practice Address - Fax:787-884-5489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89190Medicare ID - Type Unspecified