Healthcare Provider Details

I. General information

NPI: 1114504255
Provider Name (Legal Business Name): BEVERLEY CRUZ ALFONSO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEVERLEY CRUZ MD

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 SW 117TH AVE STE 304
MIAMI FL
33183-4826
US

IV. Provider business mailing address

5801 POSTAL RD
CLEVELAND OH
44181-2184
US

V. Phone/Fax

Practice location:
  • Phone: 305-226-5651
  • Fax: 305-226-2424
Mailing address:
  • Phone: 561-300-2410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME173208
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: