Healthcare Provider Details

I. General information

NPI: 1467005488
Provider Name (Legal Business Name): CHRISTIAN G NAVARRO CRUZ CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 LIVE OAK BLVD
SAINT CLOUD FL
34771-8408
US

IV. Provider business mailing address

2013 LIVE OAK BLVD STE N
SAINT CLOUD FL
34771-8410
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-6611
  • Fax:
Mailing address:
  • Phone: 787-507-4021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9436116
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number11005627
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: