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General NPI Number Information
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NPI Number | 1093309510
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Entity Type | Individual
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Provider Name | EDDY JIMENEZ CRUZ
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Gender | Male
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 14831 N FLORIDA AVE
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City | TAMPA
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State | FL
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Zip | 33613-1825
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Country | US
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Telephone | 813-330-2737
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Fax | 813-210-9205
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Provider Business Mailing Address
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Address Line | 17320 LYNNETTE DR
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City | LUTZ
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State | FL
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Zip | 33549-5608
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Country | US
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Telephone | 813-580-4427
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11011580
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License Number State | FL
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