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Individual

MR. JOHMARC DELA CRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN, CPNP-PC

Contact information

Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4742
(813) 974-2191
Mailing address
1710 PENRITH LOOP, ORLANDO, FL 32824-4250

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11026121
FL

Other

Enumeration date
09/29/2023
Last updated
01/15/2024
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