| Henry De Jesus De La Cruz Llc | |
|
Ave Sanchez Ozorio Esq Via 1 Villa Fontana Carolina PR 00983 | |
| (787) 963-0317 | |
| (787) 963-0318 |
| Full Name | Henry De Jesus De La Cruz Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | Ave Sanchez Ozorio Esq Via 1 Villa Fontana, Carolina, Puerto Rico |
| Authorized Official Name and Position | Henry De Jesus De La Cruz (PRESIDENTE) |
| Authorized Official Contact | 7879630317 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Henry De Jesus De La Cruz Llc 9 Calle Violeta Apt 702 Carolina PR 00979-7370 Ph: (787) 963-0317 | Henry De Jesus De La Cruz Llc Ave Sanchez Ozorio Esq Via 1 Villa Fontana Carolina PR 00983 Ph: (787) 963-0317 |
| NPI Number | 1477209898 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 02/24/2022 |
| Medicare PECOS PAC ID | 2961879028 |
|---|---|
| Medicare Enrollment ID | O20221102000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477209898 | NPI | - | NPPES |
| 1174940068 | Other | PR | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Henry De Jesus-de La Cruz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174940068 PECOS PAC ID: 6305266032 Enrollment ID: I20201020000561 |
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