Healthcare Provider Details

I. General information

NPI: 1447697206
Provider Name (Legal Business Name): JANET CRUZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2013
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 N ORANGE BLOSSOM TRL STE 100C
KISSIMMEE FL
34744-2307
US

IV. Provider business mailing address

19330 JESSE LN STE 100
RIVERSIDE CA
92508-5077
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-4190
  • Fax: 407-303-4192
Mailing address:
  • Phone: 844-827-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT204765
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT204765
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME172428
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: