Leoniv Roldan Dela Cruz

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22789 Issued in MA

Practice address

1520 NW 125TH Ave Apt 10301
Sunrise, FL 33323-5241

Phone

(407) 247-8714

NPI assigned

Jan 12, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1639615891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 NW 125TH AVE APT 10301",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333235241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 NW 125TH AVE APT 10301",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333235241",
            "telephone_number": "407-247-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "LEONIV",
        "middle_name": "ROLDAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22789",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "10825",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "W2320 50100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Mae Uy Decena, PT
• Michael Decker, M.D.
• Gregory Lawrence Deitsch, M.D.
• Abigaile Morales Del Mundo, PT
• Jorge I Del Toro, M.D.
• Marie Carmelle Quemada Dela Cruz, RPT
• Pilar Delgado, MD
• Stefanie Delgado, MD
• Henry Deloach II
• Mayte Delos Santos, CRNA

• Physical Therapist in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.