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BELTECEZAR CRUZ GOROSPE PA

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1821161209

Individual Registrant:
 BELTECEZAR CRUZ GOROSPE PA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
275 S ASPEN ST STOP 89  BUCKLEY AFB, CO 80011-9562 US
Tel: 720-847-7473  Fax: --

Contact information for business:
275 S ASPEN ST STOP 89  BUCKLEY AFB, CO 80011-9562 US
Tel: 207-847-7473  Fax: --

Registration Information:
NPI: 1821161209
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
1049956

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
NCCPA CERTIFICATE NUMBER104995601




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