Provider Demographics
NPI:1437049327
Name:CARA VACA DE LA CRUZ
Entity type:Organization
Organization Name:CARA VACA DE LA CRUZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-230-7818
Mailing Address - Street 1:915 OLD WELCOME RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-2034
Mailing Address - Country:US
Mailing Address - Phone:813-230-7818
Mailing Address - Fax:
Practice Address - Street 1:915 OLD WELCOME RD
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-2034
Practice Address - Country:US
Practice Address - Phone:813-230-7818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty