Nidsa I Martir Cruz MD PA

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME0063164 Issued in FL

Legal business name

NIDSA I MARTIR CRUZ MD PA

Practice address

26540 Ace Ave Ste H103
Leesburg, FL 34748-8279

Phone

(352) 323-0888

Fax

(352) 323-9103

NPI assigned

Sep 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nidsa I Martir Cruz, MDNPI 1346275369

Title

Owner

Phone

(352) 323-0888

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Nidsa I Martir Cruz, MD

  • Neurology Physician
  • Leesburg, FL
  • NPI 1346275369
  Medicare reassignment Authorized official
• Dante Vito Nuzzo, MD

  • Internal Medicine Physician
  • Leesburg, FL
  • NPI 1073546669
  NPD

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1356659502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490918",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347490918",
            "telephone_number": "352-323-0888",
            "fax_number": "352-323-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26540 ACE AVE STE H103",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488279",
            "telephone_number": "352-323-0888",
            "fax_number": "352-323-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIDSA I MARTIR CRUZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "MARTIR CRUZ",
        "authorized_official_first_name": "NIDSA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-323-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME0063164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371597300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.