Individual ProviderKatiusca Gonzalez CruzNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address8101 SW 72nd Ave Apt 223, Miami, FL 33143-7630(786) 975-8762PECOS EnrollmentBased on the most recent information from CMS, provider Katiusca Gonzalez Cruz does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:37 AM.Profile DetailsProvider ID1144976663Provider TypeIndividualFull NameGonzalez Cruz, KatiuscaGenderFemaleSole ProprietorYesEnumeration Date2/23/2022Last Updated2/23/2022Contact InformationPractice LocationPractice Address8101 SW 72nd Ave Apt 223, Miami, FL 33143-7630Phone(786) 975-8762FaxUnlisted FaxMailing LocationMailing Address8101 SW 72nd Ave Apt 223, Miami, FL 33143-7630Phone(786) 975-8762FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11000236Florida