Elisa Cruz Vegerano, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12991 Issued in PR

Practice address

195 South Park Blvd
St. Augustine, FL 32086

Phone

(904) 829-0814

Fax

(904) 829-0814

NPI assigned

Dec 5, 2005

Sex

Female

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1609850502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 PRESIDENTS CUP WAY",
            "address_2": "UNIT 201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923728",
            "telephone_number": "787-667-0175",
            "fax_number": "787-667-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 SOUTH PARK BLVD",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "904-829-0814",
            "fax_number": "904-829-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ VEGERANO",
        "first_name": "ELISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "12991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann Crites, ARNP,BC
• Samantha Lee Croft
• Lauren Duffey Crow, M.D.
• Crutchfield DPT, LLC
• Mayredlis Cruz Martir, DC
• Ioan Corneliu Cucoranu, M.D.
• Joshua Matthew Cuddy
• Cassey Marie Cuevas, PMHNP-BC
• Zehra Cumber, DO
• John A Cunningham, DPM

• Family Medicine Physician in St. Augustine, FL
• Providers in St. Augustine, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.