MEDICARE: DR. SERVILLANO DELA CRUZ JR. M.D.

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	207RX0202X	Medical Oncology Physician	ME81376	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255312591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SERVILLANO DELA CRUZ JR. M.D.

Provider Business Mailing Address
First Line	:	3498 N GRAYHAWK LOOP
Second Line	:
City	:	LECANTO
State	:	FL
Zip	:	34461-8466
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2231 HIGHWAY 44 W
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34453-3879
Country	:	US
Telephone Number	:	352-860-7400
Fax Number	:	352-860-7450

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

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	12/19/2024

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Directions to “ DR. SERVILLANO DELA CRUZ JR. M.D.” Practice Location

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