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General NPI Number Information
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NPI Number | 1386745891
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Entity Type | Organization
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Legal Business Name | SANTA CRUZ PACHECO, INC.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17304 WALKER AVE SUITE # 112
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City | MIAMI
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State | FL
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Zip | 33157-4389
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Country | US
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Telephone | 305-255-1555
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Fax | 305-255-1588
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Provider Business Mailing Address
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Address Line | 17304 WALKER AVE SUITE # 112
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City | MIAMI
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State | FL
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Zip | 33157-4389
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Country | US
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Telephone | 305-255-1555
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Fax | 305-255-1588
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULIO C SANTA CRUZ
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Credential |
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Telephone | 305-255-1555
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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 | 1313055
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License Number State | FL
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