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NPI Code Detail

MEDICARE: RODOLFO ANASTACIO CRUZ APRN, FNP-C

MEDICARE: RODOLFO ANASTACIO CRUZ APRN, FNP-C
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
1363LF0000XFamily Nurse PractitionerAP135151TX
2363LF0000XFamily Nurse Practitioner209032852IL
3363LF0000XFamily Nurse PractitionerC-APN.0104957-C-NPCO
4363LF0000XFamily Nurse Practitioner11030221FL

General Provider Information

NPI Number : 1922517788
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODOLFO ANASTACIO CRUZ APRN, FNP-C
Provider Business Mailing Address
First Line : PO BOX 211699
Second Line :
City : EAGAN
State : MN
Zip : 55121-3699
Country : US
Telephone Number : 866-849-0692
Fax Number : 888-973-8821
Provider Business Practice Location Address
First Line : 20405 STATE HIGHWAY 249 STE 325
Second Line :
City : HOUSTON
State : TX
Zip : 77070-2893
Country : US
Telephone Number : 866-849-0692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2017
Last Update Date : 12/10/2025

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