MEDICARE: REBECCA CRUZ BC-HIS

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	237700000X	Hearing Instrument Specialist	HAS-0559	NV

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	:	1922593144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA CRUZ BC-HIS

Provider Business Mailing Address
First Line	:	3675 S RAINBOW BLVD STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1059
Country	:	US
Telephone Number	:	702-873-5063
Fax Number	:	702-873-5065

Provider Business Practice Location Address
First Line	:	3675 S RAINBOW BLVD STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1059
Country	:	US
Telephone Number	:	702-873-5063
Fax Number	:	702-873-5065

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

Provider Enumeration Date	:	06/29/2018
Last Update Date	:	06/29/2018

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