De La Cruz, Fausto A

De La Cruz, Fausto A is an sole proprietor health care provider with primary practice located at 603 N Flamingo Rd #357, Pembroke Pines FL 33028-1023. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. De La Cruz, Fausto A can be contacted via phone (954) 450-8488.

Contact Information

Primary practice address
603 N Flamingo Rd #357 Pembroke Pines FL 33028-1023
Fax: (954) 950-8860
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0048782 Florida

Profile Details

NPI number 1376535484
LBN Legal business name De La Cruz, Fausto A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2005
Last updated Nov 18th, 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 1376535484 NPPES
Florida MEDICAID 379570500

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