Provider Demographics
NPI:1427593797
Name:CRUZ, IRIS
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 NORTH HAMPTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20903
Mailing Address - Country:US
Mailing Address - Phone:240-715-7713
Mailing Address - Fax:
Practice Address - Street 1:914 NORTH HAMPTON DRIVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20903
Practice Address - Country:US
Practice Address - Phone:240-715-7713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide