Healthcare Provider Details

I. General information

NPI: 1881519114
Provider Name (Legal Business Name): DAMARYS CRUZ DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3717 DEL PRADO BLVD S STE 3
CAPE CORAL FL
33904-7144
US

IV. Provider business mailing address

3717 DEL PRADO BLVD S STE 3
CAPE CORAL FL
33904-7144
US

V. Phone/Fax

Practice location:
  • Phone: 239-542-4442
  • Fax: 239-945-5033
Mailing address:
  • Phone: 239-542-4442
  • Fax: 239-945-5033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: