Active NPI
Evelyn Cruz, APRN
- Nurse Practitioner
- Plantation, FL
National Provider Identifier
1417015447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN3055982
- Practice address
- 9611 W Broward Blvd
Plantation, FL 33324-2334 - Phone
- (954) 424-7000
- Fax
- (954) 424-6003
- NPI assigned
- Dec 4, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | APRN3055982 | FL | |
| Nurse Practitioner | 363L00000X | APRN3055982 | FL | Primary |
Addresses
Primary practice location
9611 W Broward Blvd
Plantation, FL 33324-2334
Mailing address
900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (305) 245-8050
Other practice location 1
4972 Town Center Pkwy Unit 301
Jacksonville, FL 32246-8596
Phone (904) 642-6100
Other practice location 2
11260 Sullivan St
Riverview, FL 33578-2140
Phone (813) 689-7571
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024137400 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN3055982 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saltzman, Tanis, Pittell, Levin and Jacobson, LLC | Past | Accepting new patients | |
| Florida Arthritis & Rheumatology Associates, LLC | Past | Accepting new patients | |
| American Arthritis & Rheumatology Associates LLC | Past | Accepting new patients | |
| Saltzman, Tanis, Pittell, Levin and Jacobson | Past | Accepting new patients |
Interoperability endpoints
- ecruz@pa.trimed.direct-ci.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rheumatology Physician
- Jupiter, FL
- NPI 1598205072
-
- Rheumatology Physician
- Loxahatchee, FL
- NPI 1396159067
-
- Pediatrics Physician
- Hollywood, FL
- NPI 1639138480
-
- Pediatrics Physician
- Homestead, FL
- NPI 1265789226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1417015447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 S PINE ISLAND RD STE 800",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333243923",
"telephone_number": "305-245-8050",
"fax_number": "305-245-5950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9611 W BROWARD BLVD",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333242334",
"telephone_number": "954-424-7000",
"fax_number": "954-424-6003"
}
],
"practiceLocations": [
{
"address_1": "4972 Town Center Pkwy Unit 301",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322468596",
"country_code": "US",
"telephone_number": "904-642-6100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11260 Sullivan St",
"address_purpose": "LOCATION",
"city": "Riverview",
"state": "FL",
"postal_code": "335782140",
"country_code": "US",
"telephone_number": "813-689-7571",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRUZ",
"first_name": "EVELYN",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2023-07-05",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "APRN3055982",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN3055982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "024137400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.