Provider Demographics
NPI:1154324986
Name:D'CRUZ, ARVIND ALEX (MD,MRCP(UK))
Entity Type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:ALEX
Last Name:D'CRUZ
Suffix:
Gender:M
Credentials:MD,MRCP(UK)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 CENTURY MEDICAL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2100
Mailing Address - Country:US
Mailing Address - Phone:321-268-6111
Mailing Address - Fax:321-268-6273
Practice Address - Street 1:951 N WASHINGTON AVE
Practice Address - Street 2:PMG. HOSPITALIST.NEUROLOGY DEPT
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2163
Practice Address - Country:US
Practice Address - Phone:321-268-6111
Practice Address - Fax:321-268-6360
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2018-03-17
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
FLME1086552084D0003X, 2084S0012X, 208M00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004445800Medicaid
FL004445800Medicaid