Provider Demographics
NPI:1023019692
Name:CRUZ MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:CRUZ MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-362-7443
Mailing Address - Street 1:1490 W 49TH PL
Mailing Address - Street 2:SUITE 580
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3148
Mailing Address - Country:US
Mailing Address - Phone:305-362-7443
Mailing Address - Fax:305-827-0345
Practice Address - Street 1:1490 W 49TH PL
Practice Address - Street 2:SUITE 580
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3148
Practice Address - Country:US
Practice Address - Phone:305-362-7443
Practice Address - Fax:305-827-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0839640001Medicare ID - Type Unspecified