Individual
DESIREE ORTIZ-CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
583 S CLARIZZ BLVD, BLOOMINGTON, IN 47401-5515
(812) 676-4460
(812) 355-4092
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME50070
FL
2084N0400X
Neurology Physician
Primary
01088851A
IN
2084N0400X
Neurology Physician
ME50070
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200026780A
—
OK
Enumeration date
09/14/2006
Last updated
11/18/2022
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