Provider Demographics
NPI:1265902043
Name:CRUZ, VITOR DA CUNHA (CRNA)
Entity type:Individual
Prefix:
First Name:VITOR
Middle Name:DA CUNHA
Last Name:CRUZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 CALLE ARRIGOITIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3727
Mailing Address - Country:US
Mailing Address - Phone:305-244-3958
Mailing Address - Fax:
Practice Address - Street 1:FLORIDA HOSPITAL
Practice Address - Street 2:1500 SW 1ST AVE
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-351-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000880367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty