Provider Demographics
NPI:1518499912
Name:CRUZ, MERCEDEZ CEAIR (MD)
Entity Type:Individual
Prefix:
First Name:MERCEDEZ
Middle Name:CEAIR
Last Name: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 1:18600 FERNVIEW ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-6212
Mailing Address - Country:US
Mailing Address - Phone:813-692-8033
Mailing Address - Fax:813-605-6185
Practice Address - Street 1:18600 FERNVIEW ST STE 102
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-6212
Practice Address - Country:US
Practice Address - Phone:813-692-8033
Practice Address - Fax:813-605-6185
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME143817208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program