Individual provider Active NPI

Kady Cruz Estrada, 17872

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1003132317
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17872 Issued in PR
Practice address
1200 Carr 849
Vista Verde Apt 334a
San Juan, PR 00924-4563
Phone
(787) 969-1545
NPI assigned
Apr 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17872 PR Primary

Addresses

Primary practice location

1200 Carr 849
Vista Verde Apt 334a
San Juan, PR 00924-4563

Mailing address

PO Box 8413
Ponce, PR 00732-8413
Phone (787) 969-1545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271030400000",
    "number": "1003132317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8413",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007328413",
            "telephone_number": "787-969-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CARR 849",
            "address_2": "VISTA VERDE APT 334A",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009244563",
            "telephone_number": "787-969-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ ESTRADA",
        "first_name": "KADY",
        "credential": "17872",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.