Active NPI
Lillian I. Cruz, M.D.
- General Practice Physician
- Trujillo Alto, PR
National Provider Identifier
1306038864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 9409
- Practice address
- N14 Ave Aa
Trujillo Alto, PR 00976-3130 - Phone
- (787) 292-6820
- NPI assigned
- Aug 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 9409 | PR | Primary |
Addresses
Primary practice location
N14 Ave Aa
Trujillo Alto, PR 00976-3130
Mailing address
6097 Jasmine Vine Dr
Port Orange, FL 32128-7117
Phone (386) 690-1880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0082519 | Other | PR | MEDICARE PROVIDER NUMBER |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9409 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187308800000",
"number": "1306038864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6097 JASMINE VINE DR",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321287117",
"telephone_number": "386-690-1880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N14 AVE AA",
"city": "TRUJILLO ALTO",
"state": "PR",
"postal_code": "009763130",
"telephone_number": "787-292-6820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "LILLIAN",
"middle_name": "I.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-17",
"last_updated": "2007-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "9409",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NUMBER",
"identifier": "0082519",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Trujillo Alto, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.