Provider Demographics
NPI:1770303794
Name:CRUZ POLANCO, VALERIE (APRN-FNP)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:CRUZ POLANCO
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 PLAYA DEL SOL LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-7564
Mailing Address - Country:US
Mailing Address - Phone:407-222-7158
Mailing Address - Fax:
Practice Address - Street 1:1160 PLAYA DEL SOL LN
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-7564
Practice Address - Country:US
Practice Address - Phone:407-222-7158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF10240680363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner