Javier Cesar Leal-Cruz
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Broadway, VA
NPI 1134089782 · NPPES record last updated Nov 17, 2025
Key facts
- NPI
- 1134089782
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 12229 Jobel LN
Broadway, VA 22815-3100 - Phone
- (540) 746-5035
- NPI assigned
- Nov 17, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | VA | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | VA | Yes |
Addresses
Primary practice location
12229 Jobel LN
Broadway, VA 22815-3100
Mailing address
12229 Jobel LN
Broadway, VA 22815-3100
Other providers in Broadway, VA
- Robert Dover Harris
- Todd Hedinger
- Kathie Hiles
- Jordan Lynn Hill
- Monica P Johns
- Life Enrichment Services, LLC
- Mark Donald Mackay
- Mark Mast
- Nichelle Renee McDaniel Flowers
- Brenda McGillivray Smith
All providers in Broadway, VA · Student in an Organized Health Care Education/Training Program in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.