Active NPI
Yilian Cruz
- Medical Physician Assistant
- Miami, FL
National Provider Identifier
1710639257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 202204195961
- Practice address
- 4634 NW 27TH Ave
Miami, FL 33142-3510 - Phone
- (786) 275-4680
- Fax
- (305) 603-9934
- NPI assigned
- Jan 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Physical Therapy Clinic/Center | 261QP2000X | |||
| Primary Care Clinic/Center | 261QP2300X | |||
| Medical Physician Assistant | 363AM0700X | 202204195961 | FL | Primary |
Addresses
Primary practice location
4634 NW 27TH Ave
Miami, FL 33142-3510
Mailing address
8254 NW 165TH St
Miami Lakes, FL 33016-3472
Phone (786) 667-0070
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202204195961 | Other | FL | REGISTERED MEDICAL ASSISTANT |
| 110254700 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 202204195961 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| De la Cruz Mental Health LLC | Clinic/Center | Current | Accepting new patients |
Locations
4634 NW 27th Ave
Miami, FL 33142
Phone (305) 360-5949
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.
-
dba De la Cruz Health
- Community/Behavioral Health Agency
- Miami, FL
- NPI 1588246524
Clinic/Center
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1710639257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8254 NW 165TH ST",
"city": "MIAMI LAKES",
"state": "FL",
"postal_code": "330163472",
"telephone_number": "786-667-0070",
"fax_number": "305-603-9934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4634 NW 27TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331423510",
"telephone_number": "786-275-4680",
"fax_number": "305-603-9934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "YILIAN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-26",
"last_updated": "2023-01-17",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "202204195961",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED MEDICAL ASSISTANT",
"identifier": "202204195961",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110254700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.