Provider Demographics
NPI:1124011515
Name:CRUZ, GILBERTO MELCHOR (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:MELCHOR
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4160 W 16TH AVE STE 506
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5884
Mailing Address - Country:US
Mailing Address - Phone:305-819-4432
Mailing Address - Fax:305-819-3764
Practice Address - Street 1:4160 W 16TH AVE STE 506
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5884
Practice Address - Country:US
Practice Address - Phone:305-819-4432
Practice Address - Fax:305-819-3764
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00615142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000L6OtherPREFERRED CARE PARTNERS
FL110105175OtherRAILROAD MEDICARE
FL206582OtherAVMED
FL161304OtherSTAYWELL
FLP00080OtherDOCTOR CARE
FL2507987OtherCIGNA
FL10166888OtherCARE PLUS
FL1016688OtherWELL CARE
14848OtherBLUE CROSS BLUE SHIELD
FL026753OtherNEIGHBORHOOD HEALTH PLAN
FL210349OtherAMERIGROUP
FL370756300Medicaid