Octavio De Jesus Cruz Martinez, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11010804 Issued in FL

Practice address

2857 Grand Bend CT
Orlando, FL 32837-9185

Phone

(786) 975-5433

NPI assigned

Dec 28, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Vip Family HHC, LLC

  • Home Health Agency
  • Orlando, FL
  • NPI 1992571376

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Vip Family HHC, LLC

  • Home Health Agency
  • Orlando, FL
  • NPI 1992571376
  NPD Authorized official

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1508453309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2857 GRAND BEND CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328379185",
            "telephone_number": "786-975-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 GRAND BEND CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328379185",
            "telephone_number": "786-975-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ MARTINEZ",
        "first_name": "OCTAVIO",
        "middle_name": "DE JESUS",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11010804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Manuel Cruz Carlo
• Ana Paula Cruz Flores, RBT
• Ingrid Marie Cruz Gonzalez, PHD
• Lilibeth Cruz Lozada, DMD
• Leyshka Marie Cruz Maldonado, ARNP
• Naomi Cruz Mendez, RBT
• Hany Laura Cruz Ojeda
• Frances Francheska Cruz Pacheco, M.D.
• Azara Nina Cruz Rivera, RBT
• Luis A Cruz Rivera

• Nurse Practitioner in Orlando, FL
• Providers in Orlando, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.