Individual
DR. JAIRO B CRUZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
38192 MEDICAL CENTER AVE, ZEPHYRHILLS, FL 33540-1380
(813) 782-3233
(813) 502-5904
Mailing address
38192 MEDICAL CENTER AVE, ZEPHYRHILLS, FL 33540-1380
(813) 782-3233
(813) 502-5904
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3671
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3671
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114053700
—
FL
01
—
1326058249
GROUP NPI
FL
01
—
14X4T
BCBS INDIV ID
FL
01
—
5157370001
NSC DME PTAN
FL
01
—
L2158
MEDICARE PTAN IND
FL
01
—
PO2398421
RR MCARE INDIVIDUAL
FL
01
—
PO3671
MEDICAL LICENSE
FL
Enumeration date
07/06/2011
Last updated
01/03/2023
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