Fana-Souchet, Cruz Martina
Fana-Souchet, Cruz Martina is an individual health care provider with primary practice located at 125 Patricia Ave Ste B Ama Medical Group, Dunedin FL 34698-8100. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Fana-Souchet, Cruz Martina can be contacted via phone (727) 331-8740.Contact Information
Primary practice address
125 Patricia Ave Ste B Ama Medical Group
Dunedin FL 34698-8100
Phone: (727) 331-8740
Fax: (727) 331-8744
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | ME96750 | Florida |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME96750 | Florida |
Profile Details
| NPI number | 1811050602 |
|---|---|
| LBN Legal business name | Fana-Souchet, Cruz Martina |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Mar 30th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811050602 | NPPES |
| Florida | MEDICAID | 000875300 |
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