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General NPI Number Information
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NPI Number | 1750569042
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Entity Type | Individual
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Provider Name | JUAN HOLGUIN DE LA CRUZ MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 4801 HOLLYWOOD BLVD STE B
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6545
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Country | US
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Telephone | 954-927-5905
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Fax |
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Provider Business Mailing Address
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Address Line | 14859 SW 42ND ST
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City | MIRAMAR
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State | FL
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Zip | 33027-3335
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Country | US
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Telephone | 786-769-5885
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN666
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16995
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License Number State | PR
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