MEDICARE: CHRIS 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1518566520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS CRUZ

Provider Business Mailing Address
First Line	:	2821 E COMMERCIAL BLVD STE 205
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4216
Country	:	US
Telephone Number	:	954-904-4780
Fax Number	:	954-990-7056

Provider Business Practice Location Address
First Line	:	2821 E COMMERCIAL BLVD STE 205
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4216
Country	:	US
Telephone Number	:	954-904-4780
Fax Number	:	954-990-7056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2020
Last Update Date	:	01/12/2021

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Directions to “ CHRIS CRUZ ” Practice Location

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