Provider Demographics
NPI:1598744484
Name:RODRIGUEZ-CRUZ, LEONARDO R (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARDO
Middle Name:R
Last Name:RODRIGUEZ-CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9314 PARK WEST BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4344
Mailing Address - Country:US
Mailing Address - Phone:865-524-1869
Mailing Address - Fax:865-544-6533
Practice Address - Street 1:9314 PARK WEST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4344
Practice Address - Country:US
Practice Address - Phone:865-524-1869
Practice Address - Fax:865-544-6533
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34193207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ013110Medicaid
TN3851357Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER