Cruz, Gerardo

Cruz, Gerardo is an individual health care provider with primary practice located at 1005 Mar Walt Dr Internal Medicine Department, Fort Walton Beach FL 32547-6707. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Cruz, Gerardo can be contacted via phone (850) 863-8202.

Contact Information

Primary practice address
1005 Mar Walt Dr Internal Medicine Department Fort Walton Beach FL 32547-6707
Phone: (850) 863-8202
Fax: (850) 862-6148
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9101484 Florida

Profile Details

NPI number 1275518086
LBN Legal business name Cruz, Gerardo
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Dec 16th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275518086 NPPES
Florida MEDICAID 290987100

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