MEDICARE: GINA 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	174400000X	Specialist	1455201	FL

General Provider Information

NPI Number	:	1982533501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA CRUZ

Provider Business Mailing Address
First Line	:	11933 FROST ASTER DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-4107
Country	:	US
Telephone Number	:	973-336-9636
Fax Number	:

Provider Business Practice Location Address
First Line	:	11933 FROST ASTER DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-4107
Country	:	US
Telephone Number	:	973-336-9636
Fax Number	:

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ GINA CRUZ ” Practice Location

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