Provider Demographics
NPI:1396117289
Name:CRUZ MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:CRUZ MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-708-6097
Mailing Address - Street 1:1725 E HIGHWAY 50
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5188
Mailing Address - Country:US
Mailing Address - Phone:352-708-6097
Mailing Address - Fax:
Practice Address - Street 1:1725 E HIGHWAY 50
Practice Address - Street 2:SUITE A
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5188
Practice Address - Country:US
Practice Address - Phone:352-708-6097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty