JOSE EDGARDO GONZALEZ CRUZ IDHS NPI 1588471106

NPI Information

  • NPI: 1588471106
  • Provider Name: JOSE EDGARDO GONZALEZ CRUZ, IDHS
  • Classification: Military Health Care Provider - 1710I1002X
  • Specialization: Independent Duty Corpsman
  • Entity Type: Individual
  • Address: 5019 GREEN BLUFF CT
    SUMMERVILLE, SC
    ZIP 29485
  • Phone: (787) 478-1112

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NPI Details

Jose Edgardo Gonzalez Cruz, IDHS is an independent duty corpsman military health care provider in Summerville, SC. The provider is a Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. Jose Edgardo Gonzalez Cruz, IDHS NPI is 1588471106. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5019 GREEN BLUFF CT
SUMMERVILLE, SC
ZIP 29485-327
Phone: (787) 478-1112

The enumeration date for this NPI number is 12/17/2024 and was last updated on 12/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11710I1003XMilitary Health Care ProviderIndependent Duty Medical TechniciansNo
21710I1002XMilitary Health Care ProviderIndependent Duty CorpsmanYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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