Individual provider Active NPI

Yadiel Corrales Cruz, MD

  • Family Medicine Physician
  • South Miami, FL
National Provider Identifier
1619613635
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME170324 Issued in FL
Practice address
7031 SW 62ND Ave
South Miami, FL 33143-4701
Phone
(305) 284-7761
NPI assigned
May 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME170324 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

7031 SW 62ND Ave
South Miami, FL 33143-4701

Mailing address

7031 SW 62ND Ave
South Miami, FL 33143-4701
Phone (305) 284-7761

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250109001096 FL Practitioner - Family Practice 7012445752 Reassigns benefits to 1 organization
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME170324FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mital Medical Inc CurrentSince Jun 22, 2025 Accepting new patients

Locations

1840 W 49th St
Ste 404A
Hialeah, FL 33012
Phone (305) 828-9980

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1619613635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701",
            "telephone_number": "305-284-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701",
            "telephone_number": "305-284-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRALES CRUZ",
        "first_name": "YADIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME170324",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.