Johmarc Dela Cruz, APRN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

11026121 Issued in FL

Practice address

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742

Phone

(813) 974-2191

NPI assigned

Sep 29, 2023

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

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Central Florida Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1033139621
  NPD (past)

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1780464651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 PENRITH LOOP",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328244250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-974-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "JOHMARC",
        "name_prefix": "Mr.",
        "credential": "APRN, CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-29",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11026121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Ellen Del Toro, ARNP
• Julio Enrique Del Valle Gaytan
• Rogelio Fernando Del Valle Valladares, MD
• Tiffany Del Valle, LCSW
• Jessie Adriana Del Villar
• Madelynn Dela Cruz
• Tara Delach, M.A.
• Romuald Claude Delacroix, ARNP
• Noelle Christine Delacruz, PSY.D.
• Sayonara Delagdo Tartabull, RBT-24-394768

• Pediatric Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.