Individual
JOSE EDGARDO GONZALEZ CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDHS
Contact information
Practice address
5019 GREEN BLUFF CT, SUMMERVILLE, SC 29485-9327
(787) 478-1112
Mailing address
5019 GREEN BLUFF CT, SUMMERVILLE, SC 29485-9327
(787) 478-1112
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
1710I1003X
Independent Duty Medical Technicians
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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