Physician Compare National (NPI:1245779818)

HEALTHCARE PROVIDER: MAYREDLIS CRUZ MARTIR DC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1245779818
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274883855
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180830003435
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CRUZ MARTIR
	Individual professional last name
Provider First Name	MAYREDLIS
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LIFE CHIROPRACTIC COLLEGE
	Individual professional's medical school
Graduation Year	2016
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	145 HILDEN RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 123
	Group Practice or individual's line 2 address
City	PONTE VEDRA
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	320818403
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y