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Ivan Ariel Cruz Repollet

General Practice

Allopathic & Osteopathic Physicians

4340 W Hillsborough Ave Ste 210, Tampa, FL 33614-5522

PECOS Enrollment

This provider is enrolled in PECOS as IVAN CRUZ REPOLLET.

Based on the most recent information from CMS, provider Ivan Ariel Cruz Repollet is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1609282722
Provider Type
Individual
Full Name
Cruz Repollet, Ivan Ariel
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
7/9/2014
Last Updated
1/18/2024

Contact Information

Practice Location

4340 W Hillsborough Ave Ste 210, Tampa, FL 33614-5522

(813) 425-8970

(813) 425-8925

Mailing Location

4340 W Hillsborough Ave Ste 210, Tampa, FL 33614-5522

(813) 425-8970

(813) 425-8925

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License ME153523 Florida
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License 13,569-I Puerto Rico
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 0441252 Kansas
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License ME153523 Florida
Code 208D00000X	Description General Practice Allopathic & Osteopathic Physicians	License 19,231 Puerto Rico

Ivan Ariel Cruz Repollet

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Renaissance Medical Center Corp

Physician Partners Of America, Llc

Casta, Mayra M.

B & T Medical Center Llc

Nova Diagnostics Corp

Maga Medical Center Corp

Ramon Hugo Sanchez, M.D., Pa

Acosta Hernandez, Daris A

Collazo, Sergio

Feel Better Medical Llc