Healthcare Provider Details

I. General information

NPI: 1265902043
Provider Name (Legal Business Name): VITOR DA CUNHA CRUZ CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FLORIDA HOSPITAL 1500 SW 1ST AVE
OCALA FL
34471
US

IV. Provider business mailing address

568 CALLE ARRIGOITIA
SAN JUAN PR
00918-3727
US

V. Phone/Fax

Practice location:
  • Phone: 352-351-7200
  • Fax:
Mailing address:
  • Phone: 305-244-3958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11000880
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: