Provider Demographics
NPI:1760097281
Name:CRUZ, MARCELINO (RRT-NPS)
Entity Type:Individual
Prefix:
First Name:MARCELINO
Middle Name:
Last Name:CRUZ
Suffix:
Gender:M
Credentials:RRT-NPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 CAPE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7820
Mailing Address - Country:US
Mailing Address - Phone:407-818-3900
Mailing Address - Fax:
Practice Address - Street 1:3620 CAPE CT
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-7820
Practice Address - Country:US
Practice Address - Phone:407-818-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT120212279P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation