Provider Demographics
NPI:1790002301
Name:CRUZ-TORRES, YALIZ MARIE (MD)
Entity Type:Individual
Prefix:
First Name:YALIZ
Middle Name:MARIE
Last Name:CRUZ-TORRES
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 1:5946 CURRY FORD RD
Mailing Address - Street 2:STE 103
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-4209
Mailing Address - Country:US
Mailing Address - Phone:787-793-0083
Mailing Address - Fax:
Practice Address - Street 1:4300 GARDEN ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2937
Practice Address - Country:US
Practice Address - Phone:321-435-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17868208D00000X
FLACN788208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty