MEDICARE: VALERIE 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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1417751314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALERIE CRUZ

Provider Business Mailing Address
First Line	:	1160 PLAYA DEL SOL LN
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-7564
Country	:	US
Telephone Number	:	407-222-7158
Fax Number	:

Provider Business Practice Location Address
First Line	:	1160 PLAYA DEL SOL LN
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-7564
Country	:	US
Telephone Number	:	407-222-7158
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. VALERIE CRUZ
Credential	:	ARNP
Telephone Number	:	407-222-7158

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	04/02/2025

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