Provider Demographics
NPI:1003259946
Name:MARTINEZ CRUZ MEDICAL ASSOCIATES OF THE VILLAGES LLC
Entity Type:Organization
Organization Name:MARTINEZ CRUZ MEDICAL ASSOCIATES OF THE VILLAGES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FERNANDEZ LIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-750-6650
Mailing Address - Street 1:1400 N US HIGHWAY 441
Mailing Address - Street 2:BLDG 920 STE 922
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8975
Mailing Address - Country:US
Mailing Address - Phone:352-750-6650
Mailing Address - Fax:352-750-6651
Practice Address - Street 1:1400 N US HIGHWAY 441
Practice Address - Street 2:BLDG 920 STE 922
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8975
Practice Address - Country:US
Practice Address - Phone:352-750-6650
Practice Address - Fax:352-750-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty