Individual provider Active NPI

Maria E De la Cruz, APRN

  • Primary Care Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1417428095
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
11000482 Issued in FL
Practice address
200 Park Place Blvd
Kissimmee, FL 34741-2344
Phone
(407) 846-0023
Fax
(407) 483-0378
NPI assigned
Dec 7, 2018
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11000482 FL
Primary Care Nurse Practitioner 363LP2300X 11000482 FL Primary
Mental Health Counselor 101YM0800X 11000482 FL

Addresses

Primary practice location

200 Park Place Blvd
Kissimmee, FL 34741-2344

Mailing address

PO Box 3340
Windermere, FL 34786-3321
Phone (407) 758-6370

Other practice location 1

5979 Vineland Rd
Orlando, FL 32819-7800
Phone (407) 270-7702

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210504002057 FL Practitioner - Nurse Practitioner 0042629081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osceola Mental Health IncGroup PAC ID 2062313703, 14 clinicians

Practice addresses (Care Compare)

206 Park Place Blvd
Kissimmee, FL 34741-2344
Phone (407) 846-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11000482FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Osceola Mental Health Inc CurrentSince Sep 23, 2024 Accepting new patients
Neurological Health Associates PastSince Sep 1, 2019 Accepting new patients
Orlando Family Physicians, LLC PastSince Jan 5, 2025 Accepting new patients

Locations

200 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 846-0023

206 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 846-0023

2940 Pleasant Hill Rd
Kissimmee, FL 34746
Phone (407) 846-0023

Organizations & group practices 3

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": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1417428095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3340",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347863321",
            "telephone_number": "407-758-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PARK PLACE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412344",
            "telephone_number": "407-846-0023",
            "fax_number": "407-483-0378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5979 Vineland Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328197800",
            "country_code": "US",
            "telephone_number": "407-270-7702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "MARIA",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-07",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11000482",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11000482",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "11000482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.