Individual ProviderLiana Marie Bristol CruzNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address92 W Miller St, Orlando, FL 32806-2032(321) 841-8588PECOS EnrollmentBased on the most recent information from CMS, provider Liana Marie Bristol 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 2 days ago.Profile DetailsProvider ID1679520886Provider TypeIndividualFull NameBristol Cruz, Liana MarieCredentialARNPGenderFemaleSole ProprietorNoEnumeration Date5/31/2006Last Updated2/25/2010Contact InformationPractice LocationPractice Address92 W Miller St, Orlando, FL 32806-2032Phone(321) 841-8588Fax(321) 841-8560Mailing LocationMailing Address92 W Miller St, Orlando, FL 32806-2032Phone(321) 841-8588Fax(321) 841-8560Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2689852FloridaProvider IdentifiersIDDescriptionIssuerID263429500DescriptionMedicaidIssuerUnlistedFlorida