Provider Demographics
NPI:1104221241
Name:CRUZ, HEIDYLEEN (DC)
Entity Type:Individual
Prefix:DR
First Name:HEIDYLEEN
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40230 US HIGHWAY 27 N
Mailing Address - Street 2:SUITE 160
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-2636
Mailing Address - Country:US
Mailing Address - Phone:407-466-8266
Mailing Address - Fax:
Practice Address - Street 1:2320 NORTH BLVD W STE B
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-8961
Practice Address - Country:US
Practice Address - Phone:863-226-6300
Practice Address - Fax:863-240-0920
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-31
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor