MEDICARE: DR. VICTOR DAMASO CRUZ MD

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	208D00000X	General Practice Physician	12476	PR
2	207R00000X	Internal Medicine Physician	ME117105	FL
3	208M00000X	Hospitalist Physician	ME117105	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1861622060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR DAMASO CRUZ MD

Provider Business Mailing Address
First Line	:	1190 E WASHINGTON ST UNIT 113
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3708
Country	:	US
Telephone Number	:	813-808-3142
Fax Number	:	813-436-8927

Provider Business Practice Location Address
First Line	:	111 N 12TH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3661
Country	:	US
Telephone Number	:	813-397-3632
Fax Number	:	813-397-3601

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

Provider Enumeration Date	:	07/22/2009
Last Update Date	:	10/12/2016

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