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NPI Code Detail

MEDICARE: CARLOS ALBERTO CRUZ M.D.

MEDICARE: CARLOS ALBERTO CRUZ 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
1208000000XPediatrics Physician0101233315VA

Other Identifiers

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

General Provider Information

NPI Number : 1265452338
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS ALBERTO CRUZ M.D.
Provider Business Mailing Address
First Line : 6295 TIMARRON COVE LN
Second Line :
City : BURKE
State : VA
Zip : 22015-4076
Country : US
Telephone Number : 571-278-9340
Fax Number :
Provider Business Practice Location Address
First Line : 3327 DUKE ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-4597
Country : US
Telephone Number : 703-824-0970
Fax Number : 703-824-0972
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 12/11/2025

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