Organization
CRUZ AZUL OF WPB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DACHA CRUZ (PRESIDENT)
(561) 201-4016
Entity
Organization
Contact information
Practice address
6294 18TH ST S, WEST PALM BCH, FL 33415-5419
(561) 201-4016
Mailing address
6294 18TH ST S, WEST PALM BCH, FL 33415-5419
(561) 201-4016
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
LE91892
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891785994
COMERCIAL INSURANCES PPO HMO
FL
Enumeration date
08/30/2011
Last updated
08/30/2011
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