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General NPI Number Information
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NPI Number | 1336136167
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Entity Type | Individual
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Provider Name | VANESSA I DIAZ-CRUZ MD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 700 W OAK ST
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City | KISSIMMEE
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State | FL
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Zip | 34741-4924
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Country | US
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Telephone | 407-846-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 W SUNRISE BLVD
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City | PLANTATION
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State | FL
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Zip | 33322-4113
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Country | US
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Telephone |
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | ME0081889
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License Number State | FL
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