1063577575 NPI number — MRS. PAZ ACUNA FERNANDEZ-CRUZ MD

Table of content: MRS. PAZ ACUNA FERNANDEZ-CRUZ MD (NPI 1063577575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063577575 NPI number — MRS. PAZ ACUNA FERNANDEZ-CRUZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNANDEZ-CRUZ
Provider First Name:
PAZ
Provider Middle Name:
ACUNA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063577575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 ARTHUR GODFREY SUITE 301
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-535-3550
Provider Business Mailing Address Fax Number:
786-221-4435

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 ARTHUR GODFREY
Provider Second Line Business Practice Location Address:
777 ARTHUR GODFREY SUITE 301
Provider Business Practice Location Address City Name:
MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-535-3550
Provider Business Practice Location Address Fax Number:
786-221-4435
Provider Enumeration Date:
12/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  ME92162 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00314872B , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com