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General NPI Number Information
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NPI Number | 1053492652
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Entity Type | Individual
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Provider Name | GUADALUPE A CRUZ
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 12/18/2015
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Provider Practice Location Address
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Address Line | 6850 CORAL WAY SUITE #204
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City | MIAMI
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State | FL
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Zip | 33155-1758
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Country | US
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Telephone | 786-773-2558
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Fax | 305-728-0526
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Provider Business Mailing Address
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Address Line | 390 SE 9TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-5530
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Country | US
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Telephone | 786-423-4580
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Fax | 305-594-2871
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 80309
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License Number State | FL
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