Individual
RICHARD ALAN DELACRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3625 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4207
(904) 399-6811
(904) 346-0113
Mailing address
PO BOX 860554, ORLANDO, FL 32886-0554
(904) 346-3606
(904) 346-0113
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME80275
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780120
—
LA
05
—
260605400
—
FL
01
—
51797
BCBS
FL
01
—
930111454
RAILROAD MEDICARE
FL
Enumeration date
08/10/2006
Last updated
04/29/2013
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