Healthcare Provider Details

I. General information

NPI: 1861622060
Provider Name (Legal Business Name): VICTOR DAMASO CRUZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4907 N FLORIDA AVE STE D
TAMPA FL
33603-2119
US

IV. Provider business mailing address

401 E JACKSON ST STE 2340
TAMPA FL
33602-5226
US

V. Phone/Fax

Practice location:
  • Phone: 813-285-5919
  • Fax: 813-336-8688
Mailing address:
  • Phone: 813-285-5919
  • Fax: 813-336-8688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME117105
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME117105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: