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NPI Code Detail

MEDICARE: SOFIA CRUZ

MEDICARE: SOFIA 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
1225100000XPhysical Therapist4294NV

General Provider Information

NPI Number : 1316555147
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOFIA CRUZ
Provider Business Mailing Address
First Line : 2445 AVENIDA FAMILIA
Second Line :
City : HENDERSON
State : NV
Zip : 89074-6322
Country : US
Telephone Number : 702-856-6789
Fax Number :
Provider Business Practice Location Address
First Line : 6823 PONDEROSA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-2100
Country : US
Telephone Number : 702-338-2533
Fax Number : 702-796-6310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2020
Last Update Date : 07/17/2020

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Directions to “ SOFIA CRUZ ” Practice Location

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