Healthcare Provider Details

I. General information

NPI: 1508845678
Provider Name (Legal Business Name): EDWIN RODOLFO CRUZ-ZENO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 E PRINCETON ST STE 240
ORLANDO FL
32803-1465
US

IV. Provider business mailing address

615 E PRINCETON ST STE 240
ORLANDO FL
32803-1465
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-1405
  • Fax: 407-303-1406
Mailing address:
  • Phone: 407-303-1405
  • Fax: 407-303-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License NumberME134808
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: