Provider Demographics
NPI:1295591063
Name:CRUZ, CHRISTIAN JOE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:JOE
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:D12 CALLE 3A
Mailing Address - Street 2:URB. HILLSIDE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5209
Mailing Address - Country:US
Mailing Address - Phone:805-863-2722
Mailing Address - Fax:
Practice Address - Street 1:D12 CALLE 3A
Practice Address - Street 2:URB. HILLSIDE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5209
Practice Address - Country:US
Practice Address - Phone:805-863-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24567208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice