Individual
DR. NIDSA I MARTIR CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
26540 ACE AVE STE H103, LEESBURG, FL 34748-8279
(352) 323-0888
(352) 323-9103
Mailing address
27615 HWY 27, SUITE 109 #308, LEESBURG, FL 34749-9396
(352) 323-0888
(352) 323-9103
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME63164
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130012170
RAILROAD MEDICARE
FL
05
—
371597300
—
FL
Enumeration date
07/11/2006
Last updated
06/14/2024
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