Provider Demographics
NPI:1336995216
Name:CRUZ-DEL VALLE, DILLON E (DC)
Entity type:Individual
Prefix:
First Name:DILLON
Middle Name:E
Last Name:CRUZ-DEL VALLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 HARDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8290
Mailing Address - Country:US
Mailing Address - Phone:407-807-1210
Mailing Address - Fax:
Practice Address - Street 1:110 N KIRKMAN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-1404
Practice Address - Country:US
Practice Address - Phone:407-291-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL01-0681151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor