Provider Demographics
NPI:1467511816
Name:CRUZ, NARLITO V (MD)
Entity type:Individual
Prefix:DR
First Name:NARLITO
Middle Name:V
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2619 CENTENNIAL BLVD
Mailing Address - Street 2:103
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0587
Mailing Address - Country:US
Mailing Address - Phone:850-656-7720
Mailing Address - Fax:850-656-7729
Practice Address - Street 1:2619 CENTENNIAL BLVD
Practice Address - Street 2:103
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0587
Practice Address - Country:US
Practice Address - Phone:850-656-7720
Practice Address - Fax:850-656-7729
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL75761207K00000X
GA45758207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004211500Medicaid
GA00802227AMedicaid
GA00802227AMedicaid
GAG79241Medicare UPIN
FLFN893ZMedicare UPIN