Provider Demographics
NPI:1962480145
Name:CRUZ-HILLIS, EMILIANA RAYMUNDO (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILIANA
Middle Name:RAYMUNDO
Last Name:CRUZ-HILLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:EMILIANA
Other - Middle Name:RAYMUNDO
Other - Last Name:HILLIS
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 836407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-0001
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:5880 RAND BLVD
Practice Address - Street 2:200
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5118
Practice Address - Country:US
Practice Address - Phone:941-923-5882
Practice Address - Fax:941-923-1453
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98119207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277951000Medicaid
FL93601OtherBCBS
FL277951000Medicaid
FLAE821ZMedicare PIN