Provider Demographics
NPI:1770256059
Name:PEREZ CRUZ, DAVID ROLANDO SR (ARNP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ROLANDO
Last Name:PEREZ CRUZ
Suffix:SR
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4507 N ARMENIA AVE FL 33603
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2703
Mailing Address - Country:US
Mailing Address - Phone:813-876-4100
Mailing Address - Fax:
Practice Address - Street 1:4507 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2703
Practice Address - Country:US
Practice Address - Phone:813-876-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-31
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily