Individual provider Active NPI

Maurice Cruz, M.D.

  • Pediatric Pulmonology Physician
  • Mangonia Park, FL
National Provider Identifier
1356337802
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
0055895 Issued in FL
Practice address
927 45TH St Ste 202-6
Mangonia Park, FL 33407-2450
Phone
(561) 558-1212
Fax
(561) 558-1292
NPI assigned
Sep 21, 2005
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 0055895 FL Primary

Addresses

Primary practice location

927 45TH St Ste 202-6
Mangonia Park, FL 33407-2450

Mailing address

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 661-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040922001081 FL Practitioner - Pediatric Medicine 3870561202 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0055895FLMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Medical Services, Inc Pediatric Pulmonology CurrentSince Aug 1, 2014 Accepting new patients
Kidz Medical Services Inc. CurrentSince Aug 1, 2014 Accepting new patients

Locations

9980 Central Park Blvd N
Ste 318
Boca Raton, FL 33428
Phone (561) 451-0500

5955 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 662-8668

975 Baptist Way
Ste 203
Homestead, FL 33033
Phone (305) 242-8200

927 45th St
Ste 206
Mangonia Park, FL 33407
Phone (561) 844-8354

5325 Greenwood Ave
Ste 203
West Palm Beach, FL 33407
Phone (561) 442-5255

5325 Greenwood Ave
Ste 301
West Palm Beach, FL 33407
Phone (561) 273-4333

Interoperability endpoints

  • Direct secure messaging: mauricecruz@kms.allscriptsdirect.net
  • Direct secure messaging: mcruz19600@jupitermedicalcenter.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1356337802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 45TH ST STE 202-6",
            "city": "MANGONIA PARK",
            "state": "FL",
            "postal_code": "334072450",
            "telephone_number": "561-558-1212",
            "fax_number": "561-558-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "0055895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mangonia Park, FL

Sources for this page

Verify at the official NPI Registry.