Individual
MR. FAUSTO A DE LA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
603 N FLAMINGO RD, #357, PEMBROKE PINES, FL 33028-1023
(954) 450-8488
(954) 950-8860
Mailing address
603 N FLAMINGO RD, #357, PEMBROKE PINES, FL 33028-1023
(954) 450-8488
(954) 450-8860
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0048782
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379570500
—
FL
Enumeration date
08/16/2005
Last updated
11/18/2009
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