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NPI Code Detail

MEDICARE: AUDREY SUE LEGASPI CRUZ M.D.

MEDICARE: AUDREY SUE LEGASPI 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
1207R00000XInternal Medicine PhysicianA145334CA
2207R00000XInternal Medicine Physician20673NV
3207R00000XInternal Medicine PhysicianME162845FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
220673OTHERNVSTATE LICENSE

General Provider Information

NPI Number : 1427435015
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY SUE LEGASPI CRUZ M.D.
Provider Business Mailing Address
First Line : 6355 S BUFFALO DR FL 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2133
Country : US
Telephone Number : 702-216-3346
Fax Number : 702-671-6883
Provider Business Practice Location Address
First Line : 9550 S EASTERN AVE STE 253
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-8042
Country : US
Telephone Number : 888-803-3370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2015
Last Update Date : 01/28/2026

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