MARISSA CRANDALL CRUZ (NPI# 1194123638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194123638 |
| Entity Type | Individual |
| Full Name | MARISSA CRANDALL CRUZ |
| Credential | D.M.D., M.S |
| Practice Address |
26540 Ace Ave Leesburg FL 34748-8279 |
| Mailing Address |
949 N 14th St Leesburg FL 34748-3838 |
| Practice Telephone | 3523264404 |
| Mailing Telephone | 3524600164 |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2019-12-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | DS039658 | PA | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN23797 | FL | Dental Providers |
| Street Address |
26540 ACE AVE |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-8279 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437156478 | Precision Home Health Care | Home Health | 26540 Ace Ave, Suite 101 - J, Leesburg, FL 34748-8279 | 2005-07-06 |
| 1316279565 | Endeavor Chiropractic LLC | Chiropractor | 26540 Ace Ave, Suite 108, Leesburg, FL 34748-8279 | 2010-02-12 |
| 1104017946 | To Your Health of Lake County Inc | Internal Medicine | 26540 Ace Ave, Suite 108c, Leesburg, FL 34748-8279 | 2007-08-07 |
| 1578766119 | Florida Heart & Vascular Multi Specialty Group, Pa | Family Medicine | 26540 Ace Ave, Suite 108, Leesburg, FL 34748-8279 | 2007-06-11 |
| 1639380322 | Epic Teleradiology LLC | Radiology | 26540 Ace Ave, Suite A, Leesburg, FL 34748-8279 | 2007-05-24 |
| 1265596928 | Mohamed Nazih Ayadi | Specialist | 26540 Ace Ave, Suire 109-a, Leesburg, FL 34748-8279 | 2006-12-20 |
| 1639258072 | Tonya M Terwilliger | Physician Assistant | 26540 Ace Ave, Suite 107, Unit D, Leesburg, FL 34748-8279 | 2006-11-05 |
| 1588741979 | Highland Chiropractic Inc | Chiropractor | 26540 Ace Ave, Leesburg, FL 34748-8279 | 2006-11-01 |
| 1174610067 | Joseph L Carrasco | Internal Medicine | 26540 Ace Ave, Suite 108c, Leesburg, FL 34748-8279 | 2006-10-10 |
| 1053420364 | Brian Lewis Mundy | Physical Therapist | 26540 Ace Ave, Ste B, Leesburg, FL 34748-8279 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344354 | Philipkjosephsllc | Dentist | 161 Monterey Bay Dr, Boynton Beach, FL 33426-8438 | 2020-10-21 |
| 1194322651 | Peter Tsambazis Dmd, Inc | Dentist | 6654 Collier Blvd Unit 104, Naples, FL 34114-8179 | 2020-10-07 |
| 1265041578 | Lauren Elise Steinberg | Dentist | 7301 W Palmetto Park Rd Ste 303a, Boca Raton, FL 33433-3458 | 2020-07-23 |
| 1306462213 | Miami Healthy Smiles | Dentist | 8861 Sw 69th Ct, Pinecrest, FL 33156-1605 | 2020-06-17 |
| 1619591393 | Advanced Periodontics & Implant Care, LLC | Dentist | 1950 Laurel Manor Drive #184, The Villages, FL 32162 | 2020-05-29 |
| 1437785847 | Modern Dental Cape Coral Pllc | Dentist | 706 Sw Pine Island Rd, Suite 103, Cape Coral, FL 33991 | 2020-03-17 |
| 1437783792 | Anthony Joseph Michelotti | Dentist | 3331 Briarwood Cir, Safety Harbor, FL 34695-4691 | 2020-02-26 |
| 1417595893 | Park Plaza Dental Care | Dentist | 1144 N Federal Hwy, Pompano Beach, FL 33062-4322 | 2019-12-16 |
| 1619538832 | George Edward Tolson V | Dentist | 1739 E Commercial Blvd, Oakland Park, FL 33334-5737 | 2019-06-27 |
| 1396203485 | Michael Steven Liss | Dentist | 2600 N Military Trl Ste 310, Boca Raton, FL 33431-6315 | 2019-03-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.