Provider Demographics
NPI:1861786501
Name:CANCEL-CRUZ, NOMARIS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NOMARIS
Middle Name:
Last Name:CANCEL-CRUZ
Suffix:
Gender:F
Credentials:PHARM D
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 2309
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-2309
Mailing Address - Country:US
Mailing Address - Phone:787-367-4839
Mailing Address - Fax:787-834-2698
Practice Address - Street 1:AVE HOSTOS
Practice Address - Street 2:505
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6353
Practice Address - Country:US
Practice Address - Phone:787-367-4839
Practice Address - Fax:787-834-2698
Is Sole Proprietor?:No
Enumeration Date:2011-05-29
Last Update Date:2011-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist