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General NPI Number Information
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NPI Number | 1306281522
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Entity Type | Individual
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Provider Name | RAYMOND A SANTA-CRUZ DMD
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Gender | Male
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 4104 LITTLE RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-1721
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Country | US
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Telephone | 727-376-2666
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Fax | 727-245-8864
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Provider Business Mailing Address
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Address Line | 4104 LITTLE RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-1721
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Country | US
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Telephone | 727-376-2666
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Fax | 727-245-8864
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | DN20079
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20079
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License Number State | FL
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