MEDICARE: KATHERINE CRUZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1144666470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE CRUZ

Provider Business Mailing Address
First Line	:	3763 EVANS AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9302
Country	:	US
Telephone Number	:	239-275-3222
Fax Number	:

Provider Business Practice Location Address
First Line	:	3763 EVANS AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9302
Country	:	US
Telephone Number	:	239-275-3222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2013
Last Update Date	:	03/18/2026

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Directions to “ KATHERINE CRUZ ” Practice Location

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