MEDICARE: CHRISTIAN-JOSEPH MICIANO CRUZ APRN

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	163W00000X	Registered Nurse	RN9285211	FL
2	363L00000X	Nurse Practitioner	APRN9285211	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	:	1942685557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN-JOSEPH MICIANO CRUZ APRN

Provider Business Mailing Address
First Line	:	5901 E FOWLER AVE STE 100
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-2305
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:	813-558-6187

Provider Business Practice Location Address
First Line	:	5016 W CYPRESS ST STE 210
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-3809
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:	813-558-6187

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

Provider Enumeration Date	:	07/24/2015
Last Update Date	:	05/26/2026

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Directions to “ CHRISTIAN-JOSEPH MICIANO CRUZ APRN” Practice Location

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