Individual
MR. INTI CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4634 NW 27TH AVE, MIAMI, FL 33142-3510
(786) 275-4680
(305) 603-9934
Mailing address
8254 NW 165TH ST, MIAMI LAKES, FL 33016-3472
(786) 667-0070
(305) 603-9934
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110254700
—
FL
Enumeration date
01/26/2022
Last updated
01/31/2022
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