MEDICARE: FAMILY MEDICINE SPECIALISTS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS6875	FL

General Provider Information

NPI Number	:	1891787990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICINE SPECIALISTS PA

Provider Business Mailing Address
First Line	:	7200 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-5806
Country	:	US
Telephone Number	:	407-658-0100
Fax Number	:	407-658-5702

Provider Business Practice Location Address
First Line	:	7200 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-5806
Country	:	US
Telephone Number	:	407-658-0100
Fax Number	:	407-658-5702

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. HUMBERTO CRUZ JR.
Credential	:	DO
Telephone Number	:	407-658-0100

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	08/22/2020

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