Provider Demographics
NPI:1548321433
Name:CRUZ, LUIS ALBERTO (MD)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ALBERTO
Last Name:CRUZ
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:PO BOX 362106
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2106
Mailing Address - Country:US
Mailing Address - Phone:787-294-0350
Mailing Address - Fax:787-294-0350
Practice Address - Street 1:TORRE AUXILIO MUTUO
Practice Address - Street 2:SUITE 505 HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-294-0350
Practice Address - Fax:787-294-0352
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7486207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E50970Medicare UPIN
28928Medicare ID - Type Unspecified