Provider Demographics
NPI:1548455868
Name:CRUZ-COLON, CRISTOBAL J (MD)
Entity type:Individual
Prefix:DR
First Name:CRISTOBAL
Middle Name:J
Last Name:CRUZ-COLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CRISTOBAL
Other - Middle Name:J
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 8981
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-8981
Mailing Address - Country:US
Mailing Address - Phone:787-585-4361
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:TORRE MEDICA SAN LUCAS
Practice Address - Street 2:SUITE 708-709
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:305-598-2020
Practice Address - Fax:305-270-6418
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108974207W00000X
PR17584207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology