ROBERTO LUIS CRUZ GARCIA (NPI# 1639733207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639733207 |
| Entity Type | Individual |
| Full Name | ROBERTO LUIS CRUZ GARCIA |
| Credential | MD |
| Practice Address |
1539 Dale Mabry Hwy Ste 102 Lutz FL 33548-3008 |
| Mailing Address |
2577 Gunn Hwy Apt 217 Odessa FL 33556-2535 |
| Practice Telephone | 8139097102 |
| Mailing Telephone | 7866031877 |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2020-10-29 |
| NPI Deactivation Date | 10/17/2020 |
| NPI Reactivation Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ACN1282 | FL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Calle Sergio Cuevas Bustamante #550, San Juan, PR 00918 | 7877588383 |
| Street Address |
1539 DALE MABRY HWY STE 102 |
| City | LUTZ |
| State | FL |
| Zip Code | 33548-3008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376506394 | Jack Alton Bergh | Family Medicine | 1539 Dale Mabry Hwy Ste 102, Lutz, FL 33548 | 2006-04-10 |
| 1619504354 | Myrtle Ridge Primary Care, P.a | Nurse Practitioner | 1539 Dale Mabry Hwy Ste 102, Lutz, FL 33548-3008 | 2020-03-24 |
| 1376170225 | Myrtle Ridge Healthcare Center, LLC | Nurse Practitioner | 1539 Dale Mabry Hwy Ste 102, Lutz, FL 33548-3008 | 2020-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205337821 | Chiros On 54 LLC | Chiropractor | 1003 N Dale Mabry Hwy, Lutz, FL 33548 | 2018-02-28 |
| 1295233666 | Issac M Arroyo | Behavior Technician | 18288 Us 41, Lutz, FL 33548 | 2018-01-31 |
| 1699293225 | Lettuce Lake Emergency Physicians LLC | Physician Assistant | 1430 Dale Mabry Highway, Lutz, FL 33548 | 2017-09-04 |
| 1780010512 | Yanina Abaunza-fiallos Md Pa | Pediatrics | 17541 N. Dale Mabry Hwy., Lutz, FL 33548 | 2013-09-25 |
| 1891138459 | Atlas Medical Services, Inc | Durable Medical Equipment & Medical Supplies | 3859 Van Dyke Rd, Suite 161, Lutz, FL 33548 | 2013-04-14 |
| 1407122492 | Tania Isabel Mendoza | Pathology | 19045 N Dale Mabry Hwy, Lutz, FL 33548 | 2012-03-24 |
| 1528362944 | Life Discovery Counseling Center | Counselor | 18371 Exciting Idlewild Blvd, Lutz, FL 33548 | 2010-12-28 |
| 1356643423 | Heidi Jane Pickering | Chiropractor | 19011 N Dale Mabry, Lutz, FL 33548 | 2010-11-23 |
| 1992015762 | Yolanda R. Harper | Social Worker | 1527 Dale Mabry Hwy Ste 103, Lutz, FL 33548 | 2010-10-14 |
| 1821231846 | Michael Lee Bishop | Psychologist | 18958 N Dale Mabry Hwy, Ste 102, Lutz, FL 33548 | 2009-04-07 |
| Find all providers in zip 33548 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922441054 | Life Medical Group, LLC | General Practice | 14614 Livingston Ave, Lutz, FL 33559-3101 | 2013-04-08 |
| 1770856627 | Tampa Physicians Alliance Corp | General Practice | 5526 Terrain De Golf Dr, Lutz, FL 33558-2861 | 2012-02-22 |
| 1285835322 | Trillium Medical Group of Florida | General Practice | 1843 Collier Pkwy, Lutz, FL 33549-8718 | 2007-05-29 |
| 1558576090 | Khavir Ahmed Sharieff | General Practice | 17501 Dale Mabry Hwy N, Lutz, FL 33548 | 2007-05-10 |
| 1225087430 | Dwic of Tampa Bay, Inc. | General Practice | 22945 State Road 54, Lutz, FL 33549-6932 | 2006-05-08 |
| 1376997098 | Wwh Weightloss LLC | General Practice | 24420 State Road 54, Lutz, FL 33559-7303 | 2016-04-19 |
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| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
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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.