Most Relevant Information
Provider Data
| NPI Number: | 1003407008 |
| Provider Name: | NISSA CRUZ-VICKERS FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 11011142 |
Most Important Dates
| Enumeration Date: | 02/01/2021 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
10000 W COLONIAL DR
OCOEE
FL
347613400
Practice Location Phone/Fax
| Phone: | 4072961000 |
| Fax: |
Provider Mailing Location
9500 S DADELAND BLVD STE 200
MIAMI
FL
331562866
Provider Mailing Phone/Fax
| Phone: | 3054684185 |
| Fax: | 3056753378 |