| Jacobo A Cruz Md Pa | |
|
4400 Bayou Blvd Suite 51 Pensacola FL 32503-2673 | |
| (850) 484-7774 | |
| (850) 484-8874 |
| Full Name | Jacobo A Cruz Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4400 Bayou Blvd, Pensacola, Florida |
| Authorized Official Name and Position | Jacobo A Cruz (PRESIDENT) |
| Authorized Official Contact | 8504847774 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobo A Cruz Md Pa 4400 Bayou Blvd Suite 51 Pensacola FL 32503-2673 Ph: (850) 484-7774 | Jacobo A Cruz Md Pa 4400 Bayou Blvd Suite 51 Pensacola FL 32503-2673 Ph: (850) 484-7774 |
| NPI Number | 1952557183 |
|---|---|
| Provider Enumeration Date | 08/07/2008 |
| Last Update Date | 09/05/2008 |
| Medicare PECOS PAC ID | 3577639251 |
|---|---|
| Medicare Enrollment ID | O20080903000447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952557183 | NPI | - | NPPES |
| 048405900 | Medicaid | FL | |
| 1043301518 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME48974 (Florida) | Primary |
| Provider Name | Jacobo A Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043301518 PECOS PAC ID: 0941375620 Enrollment ID: I20080814000283 |
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