Provider Demographics
NPI:1356337802
Name:CRUZ, MAURICE (MD)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5955 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2423
Mailing Address - Country:US
Mailing Address - Phone:305-661-1515
Mailing Address - Fax:305-662-3723
Practice Address - Street 1:927 45TH ST STE 202-6
Practice Address - Street 2:
Practice Address - City:MANGONIA PARK
Practice Address - State:FL
Practice Address - Zip Code:33407-2450
Practice Address - Country:US
Practice Address - Phone:561-558-1212
Practice Address - Fax:561-558-1292
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00558952080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14293OtherSTAYWELL
FL14293OtherHEALTHEASE
FL2053218OtherAETNA
FLP211917OtherOXFORD HEALTH
FL203191OtherAVMED
FL209935OtherAMERIGROUP
FL370197200Medicaid
FL23942OtherSOUTHCARE
FL994755OtherNEIGHBORHOOD HEALTH PARTN
FL15168OtherBLUE CROSS & BLUE SHIELD
FL203191OtherAVMED
FL209935OtherAMERIGROUP