Provider Demographics
NPI:1316937501
Name:MARTINEZ-CRUZ, BAYOAN D (MD)
Entity type:Individual
Prefix:DR
First Name:BAYOAN
Middle Name:D
Last Name:MARTINEZ-CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11950 COUNTY ROAD 101
Mailing Address - Street 2:STE 206
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-9334
Mailing Address - Country:US
Mailing Address - Phone:352-750-6650
Mailing Address - Fax:352-750-6651
Practice Address - Street 1:11950 COUNTY ROAD 101
Practice Address - Street 2:STE 206
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-9334
Practice Address - Country:US
Practice Address - Phone:352-750-6650
Practice Address - Fax:352-750-6651
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94977207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279919700Medicaid
FL279919700Medicaid
FLAH739ZMedicare PIN