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Individual

DR. CRUZ MARTINA FANA-SOUCHET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
125 PATRICIA AVE STE B, AMA MEDICAL GROUP, DUNEDIN, FL 34698-8100
(727) 331-8740
(727) 331-8744
Mailing address
125 PATRICIA AVE STE B, AMA MEDICAL GROUP, DUNEDIN, FL 34698-8100
(727) 331-8740
(727) 331-8744

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME96750
FL
207RI0200X
Infectious Disease Physician
ME96750
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000875300
FL
Enumeration date
12/19/2006
Last updated
03/30/2011
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