| Organization Name: | CRUZ AZUL OF WPB |
| NPI Number: | 1811278245 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DACHA CRUZ (PRESIDENT) |
| Mailing Address: | 6294 18th St S West Palm Bch |
| State: | FL US |
| Postal Code: | 334155419 |
| Phone Number: | 5612014016 |
| Fax Number: | |
| NPI Enumeration Date: | 08/30/2011 |
| NPI Last Update Date: | 08/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | LE91892 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |