Organization Active NPI

Alejandro Eloy de la Cruz MD PA

  • Medical Specialty Clinic/Center
  • Miami, FL
National Provider Identifier
1720375306
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
ME 109588 Issued in FL
Legal business name
ALEJANDRO ELOY DE LA CRUZ MD PA
Practice address
13214 SW 8TH St
Miami, FL 33184-1176
Phone
(305) 831-2789
Fax
(305) 440-4089
NPI assigned
Jul 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Dr. Alejandro Eloy De la Cruz, MDNPI 1245521186
Title
President
Phone
(305) 831-2789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X ME 109588 FL
Medical Specialty Clinic/Center 261QM2500X ME 109588 FL Primary

Addresses

Primary practice location

13214 SW 8TH St
Miami, FL 33184-1176

Mailing address

155 SW 136TH Ave
Miami, FL 33184-1017
Phone (305) 831-2789

Other identifiers 2

IdentifierTypeStateIssuer
FJ643ZOtherFLPTAN
004142600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110921000554 FL Part B Supplier - Clinic/Group Practice 4385815471 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

4114 W 12th Ave
Hialeah, FL 33012
Phone (305) 824-8663

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1720375306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 SW 136TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331841017",
            "telephone_number": "305-831-2789",
            "fax_number": "305-440-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13214 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331841176",
            "telephone_number": "305-831-2789",
            "fax_number": "305-440-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEJANDRO ELOY DE LA CRUZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "DE LA CRUZ",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_middle_name": "ELOY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-831-2789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "ME 109588",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME 109588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "FJ643Z",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004142600",
            "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 Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.