Provider Demographics
NPI:1871609115
Name:CRUZ, FLORIDALIA (MD)
Entity type:Individual
Prefix:DR
First Name:FLORIDALIA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 S SEMORAN BLVD STE 26
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-1781
Mailing Address - Country:US
Mailing Address - Phone:407-401-8637
Mailing Address - Fax:407-401-8610
Practice Address - Street 1:5575 S SEMORAN BLVD STE 26
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1781
Practice Address - Country:US
Practice Address - Phone:407-401-8637
Practice Address - Fax:407-401-8610
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267755500Medicaid
FL2410661OtherUNITED HEALTH CARE
FL243091OtherAMERIGROUP
FL266478OtherWELLCARE
FL243091OtherAMERIGROUP