Organization
MD AND WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE LUIS CRUZ MD (PRESIDENT/MEDICAL DIRECTOR)
(813) 876-7700
Entity
Organization
Contact information
Practice address
4730 N HABANA AVE STE 300, TAMPA, FL 33614-7148
(813) 876-7700
(813) 876-8700
Mailing address
2541 N DALE MABRY HWY UNIT 413, TAMPA, FL 33607-2408
(813) 876-7700
(813) 876-8700
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003245000
—
FL
05
—
280564200
—
FL
Enumeration date
11/15/2012
Last updated
03/23/2022
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