Provider Demographics
NPI:1801286729
Name:CRUZ PENA, LINNETTE (MSPT)
Entity type:Individual
Prefix:
First Name:LINNETTE
Middle Name:
Last Name:CRUZ PENA
Suffix:
Gender:F
Credentials:MSPT
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 393
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0393
Mailing Address - Country:US
Mailing Address - Phone:787-280-0099
Mailing Address - Fax:
Practice Address - Street 1:1003 AVE EMERITO ESTRADA RIVERA
Practice Address - Street 2:SUITE 8
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-3018
Practice Address - Country:US
Practice Address - Phone:787-280-0099
Practice Address - Fax:787-280-0099
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist