Individual provider Active NPI

Dellanida Fernandez Cruz

  • Behavior Technician
  • Miami Gardens, FL
National Provider Identifier
1679723530
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
18533 NW 53Rd Ave
Miami Gardens, FL 33055-5341
Phone
(786) 291-0445
NPI assigned
Sep 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA53409 FL
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

18533 NW 53Rd Ave
Miami Gardens, FL 33055-5341

Mailing address

18533 NW 53Rd Ave
Miami Gardens, FL 33055-5341

Other practice location 1

6501 NW 36th St Ste 390
Virginia Gardens, FL 33166-6963
Phone (305) 871-0920

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA53409FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1679723530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18533 NW 53RD AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330555341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18533 NW 53RD AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330555341",
            "telephone_number": "786-291-0445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6501 NW 36th St Ste 390",
            "address_purpose": "LOCATION",
            "city": "Virginia Gardens",
            "state": "FL",
            "postal_code": "331666963",
            "country_code": "US",
            "telephone_number": "305-871-0920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ CRUZ",
        "first_name": "DELLANIDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA53409",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.