Individual
DR. ROBERT CRUZ VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40100 HIGHWAY 27, DAVENPORT, FL 33837-5900
(863) 422-4971
(863) 419-2264
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036115480
IL
207P00000X
Emergency Medicine Physician
87392
SC
207P00000X
Emergency Medicine Physician
ME95775
FL
207Q00000X
Family Medicine Physician
036115480
IL
207Q00000X
Family Medicine Physician
072944
GA
207Q00000X
Family Medicine Physician
ME95775
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036115480
—
IL
05
—
036115480-4
—
IL
01
—
3932056
BLUE SHIELD
IL
Enumeration date
05/23/2006
Last updated
03/19/2022
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