Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN19385 | FL |
Y | 213EG0000X | General Practice | DN19385 | FL |
NPI | 1003102708 |
---|---|
Provider Name | Dr. Yulien Cruz-Davis |
First Address | Archer, FL 32618-4119 |
Second Address | Gainesville, FL 32606-6649 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2011 |
Last Update Date | 02/05/2013 |