Jose Miguel De la Cruz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14950 Issued in FL

Practice address

6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593

Phone

(407) 801-2191

NPI assigned

May 21, 2019

Last updated

May 29, 2020By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revibe Therapy PLLC

  dba Revibe Therapy

  • Clinical Social Worker
  • Orlando, FL
  • NPI 1457919516
  Authorized official Same address or phone

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1629635073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 LANDING POINT LOOP",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328325904",
            "telephone_number": "407-801-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 TAVISTOCK LAKES BLVD STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277593",
            "telephone_number": "407-801-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "JOSE",
        "middle_name": "MIGUEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "14950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ed L De la Cruz Rodriguez, PHARMD
• Genaro Antonio De la Cruz Soto, RN, BSN
• Jackeline De la Cruz Soto, RN, BSN
• Anna Marie R. De la Cruz, APRN
• Elly De la Cruz
• Katherine De la Cruz, ITDS
• Maria De la Cruz
• Mavel De la Cruz
• Susel De la Cruz
• Sebastian De la Fuente, MD

• Clinical Social Worker in Orlando, FL
• Providers in Orlando, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.