Provider Demographics
NPI:1326127044
Name:FELIZ CRUZ, MARLENNY (MD)
Entity Type:Individual
Prefix:
First Name:MARLENNY
Middle Name:
Last Name:FELIZ CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18503 PINES BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1406
Mailing Address - Country:US
Mailing Address - Phone:954-442-0784
Mailing Address - Fax:855-840-7185
Practice Address - Street 1:1779 N UNIVERSITY DR STE 102
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-0929
Practice Address - Country:US
Practice Address - Phone:954-885-6565
Practice Address - Fax:888-727-7735
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1030577700Medicaid