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General NPI Number Information
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NPI Number | 1407035306
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Entity Type | Individual
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Provider Name | LUIS J FELIZ DE LA CRUZ M.D
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Gender | Male
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 9400 TURKEY LAKE RD MP 452
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City | ORLANDO
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State | FL
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Zip | 32819-8001
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Country | US
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Telephone | 321-843-5500
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Fax | 321-843-5550
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Provider Business Mailing Address
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Address Line | 9400 TURKEY LAKE RD MP 452
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City | ORLANDO
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State | FL
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Zip | 32819-8001
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Country | US
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Telephone | 321-843-5500
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Fax | 321-843-5550
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 125-050185
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 46890
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME113750
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License Number State | FL
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