Healthcare Provider Details

I. General information

NPI: 1447587647
Provider Name (Legal Business Name): MARIA D CRUZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 01/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 DELAWARE AVE
FORT PIERCE FL
34950-3975
US

IV. Provider business mailing address

4450 S TIFFANY DR
WEST PALM BEACH FL
33407-3241
US

V. Phone/Fax

Practice location:
  • Phone: 772-461-1402
  • Fax: 772-461-9491
Mailing address:
  • Phone: 561-844-9443
  • Fax: 561-844-1013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9182872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: