Provider Demographics
NPI:1063704724
Name:CRUZ, EUCLID ANGELES (PA-C)
Entity type:Individual
Prefix:
First Name:EUCLID
Middle Name:ANGELES
Last Name:CRUZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 CLEARFIELD AVE STE 124
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1832
Mailing Address - Country:US
Mailing Address - Phone:757-321-3300
Mailing Address - Fax:757-321-3330
Practice Address - Street 1:733 VOLVO PKWY STE 300
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1610
Practice Address - Country:US
Practice Address - Phone:757-321-3300
Practice Address - Fax:757-321-3330
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1097195363A00000X
VA0110008700363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant