Individual provider Active NPI

Gustavo De la Cruz, FAMILY NURSE PRACTIT

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1467197483
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0422041 Issued in FL
Practice address
2945 SW 8TH St
Miami, FL 33135-2826
Phone
(786) 577-5470
Fax
(786) 717-5844
NPI assigned
May 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0422041 FL Primary

Addresses

Primary practice location

2945 SW 8TH St
Miami, FL 33135-2826

Mailing address

1085 Nightingale Ave
Miami Springs, FL 33166-3828
Phone (305) 725-1896

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

LicenseStateTypeSpecialty
F0422041FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1467197483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 NIGHTINGALE AVE",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331663828",
            "telephone_number": "305-725-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352826",
            "telephone_number": "786-577-5470",
            "fax_number": "786-717-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "GUSTAVO",
        "credential": "FAMILY NURSE PRACTIT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F0422041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.