Organization Active NPI

De la Cruz Healthcare Corp

  • Psychiatric/Mental Health Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1124704507
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
DE LA CRUZ HEALTHCARE CORP
Practice address
971 Chiquita Blvd S
Cape Coral, FL 33991-2143
Phone
(786) 351-4243
NPI assigned
Jun 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Ms. Mairelis De la Cruz Hernandez, APRNNPI 1588295919
Title
Nurse Practitioner
Phone
(786) 351-4243

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

971 Chiquita Blvd S
Cape Coral, FL 33991-2143

Mailing address

971 Chiquita Blvd S
Cape Coral, FL 33991-2143
Phone (786) 351-4243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250329000186 FL Part B Supplier - Clinic/Group Practice 8022531110 Receives reassigned benefits from 1 practitioner
Practice locations: Cape Coral, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1124704507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 CHIQUITA BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912143",
            "telephone_number": "786-351-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 CHIQUITA BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912143",
            "telephone_number": "786-351-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE LA CRUZ HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-22",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "DE LA CRUZ HERNANDEZ",
        "authorized_official_first_name": "MAIRELIS",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "786-351-4243",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.