Individual
LEIVYS CRUZ MARSALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1004 W LINEBAUGH AVE STE A, TAMPA, FL 33612-7837
(813) 443-5370
Mailing address
10789 IRONWOOD TREE WAY, SAN ANTONIO, FL 33576-7370
(954) 774-7690
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2180PA
PR
363A00000X
Physician Assistant
TPPA800
FL
363AM0700X
Medical Physician Assistant
Primary
PACN66
FL
Other
Enumeration date
10/14/2024
Last updated
03/27/2026
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