Active NPI
Javier De la Cruz, ARNP
- Family Nurse Practitioner
- Miami, FL
National Provider Identifier
1124064415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 9311530
- Practice address
- 9804 SW 40TH St
Miami, FL 33165-3912 - Phone
- (786) 319-3773
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9311530 | FL | Primary |
Addresses
Primary practice location
9804 SW 40TH St
Miami, FL 33165-3912
Mailing address
9804 SW 40TH St
Miami, FL 33165-3912
Phone (786) 319-3773
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 760893400 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9311530 | FL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366243200000",
"number": "1124064415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9804 SW 40TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331653912",
"telephone_number": "786-319-3773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9804 SW 40TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331653912",
"telephone_number": "786-319-3773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA CRUZ",
"first_name": "JAVIER",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2013-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "9311530",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "760893400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.