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NPI Code Detail

MEDICARE: DR. JAN DELA CRUZ DO

MEDICARE: DR. JAN DELA CRUZ DO
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
1207Q00000XFamily Medicine PhysicianOS21554FL

General Provider Information

NPI Number : 1285364547
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAN DELA CRUZ DO
Provider Business Mailing Address
First Line : 2627 RIVERSIDE AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32204-4717
Country : US
Telephone Number : 904-308-7372
Fax Number :
Provider Business Practice Location Address
First Line : 2627 RIVERSIDE AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32204-4717
Country : US
Telephone Number : 904-308-7372
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2022
Last Update Date : 03/10/2026

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Directions to “ DR. JAN DELA CRUZ DO” Practice Location

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