Provider Demographics
NPI:1730839820
Name:CRUZ MOJICA, ARIELYS ZOE
Entity type:Individual
Prefix:MISS
First Name:ARIELYS
Middle Name:ZOE
Last Name:CRUZ MOJICA
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:CATURRA STREET L-22
Mailing Address - Street 2:URBANIZATION EL CAFETAL II
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:787-901-4447
Mailing Address - Fax:
Practice Address - Street 1:1046 HOSTOS AVENUE, SUITE 118
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-841-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI41143390200000X
PR2717390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program