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General NPI Number Information
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NPI Number | 1790619682
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Entity Type | Individual
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Provider Name | JOEL RAMON DE LA CRUZ COMPRES SR. CMA, RPS
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Gender | Male
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/14/2026
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Provider Practice Location Address
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Address Line | 8405 MULLIGAN CIR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-3294
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Country | US
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Telephone | 772-208-8516
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Fax | 772-227-1480
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Provider Business Mailing Address
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Address Line | 8405 MULLIGAN CIR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-3294
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Country | US
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Telephone | 772-208-8516
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Fax | 772-227-1480
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 02-287-8128
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License Number State | NJ
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