Individual
IVAN ARIEL CRUZ REPOLLET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4340 W HILLSBOROUGH AVE STE 210, TAMPA, FL 33614-5522
(813) 425-8970
(813) 425-8925
Mailing address
4340 W HILLSBOROUGH AVE STE 210, TAMPA, FL 33614-5522
(813) 425-8970
(813) 425-8925
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0441252
KS
207Q00000X
Family Medicine Physician
ME153523
FL
208D00000X
General Practice Physician
19,231
PR
208D00000X
General Practice Physician
Primary
ME153523
FL
390200000X
Student in an Organized Health Care Education/Training Program
13,569-I
PR
Other
Enumeration date
07/09/2014
Last updated
01/18/2024
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