Healthcare Provider Details
I. General information
NPI: 1649062126
Provider Name (Legal Business Name): EDUARDO A CRUZ DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3140 N FEDERAL HWY
LIGHTHOUSE POINT FL
33064-6738
US
IV. Provider business mailing address
3140 N FEDERAL HWY
LIGHTHOUSE POINT FL
33064-6738
US
V. Phone/Fax
- Phone: 954-532-1259
- Fax: 954-532-1273
- Phone: 954-532-1259
- Fax: 954-532-1273
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
EDUARDO
ANDRES
CRUZ
Title or Position: ENDODONTIST
Credential: DMD
Phone: 954-532-1259