Individual provider Active NPI

Lilliam Valdes-Cruz, MD

  • Pediatric Cardiology Physician
  • Cooper City, FL
National Provider Identifier
1528077401
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME96317 Issued in FL
Practice address
12880 Country Glen Dr
Cooper City, FL 33330-2743
Phone
(786) 385-0559
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X ME96317 FL Primary

Addresses

Primary practice location

12880 Country Glen Dr
Cooper City, FL 33330-2743

Mailing address

12880 Country Glen Dr
Cooper City, FL 33330-2743
Phone (786) 385-0559

Other identifiers 1

IdentifierTypeStateIssuer
276778300MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1528077401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12880 COUNTRY GLEN DR",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333302743",
            "telephone_number": "786-385-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12880 COUNTRY GLEN DR",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333302743",
            "telephone_number": "786-385-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES-CRUZ",
        "first_name": "LILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME96317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276778300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.