Individual provider Active NPI

Cristobal Diaz Cobas, APRN

  • Family Nurse Practitioner
  • Lake Worth, FL
National Provider Identifier
1841035128
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11033620 Issued in FL
Practice address
4560 Lantana Rd Ste 110
Lake Worth, FL 33463-6998
Phone
(305) 266-2929
Fax
(786) 558-0242
NPI assigned
Jun 27, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11033620 FL Primary

Addresses

Primary practice location

4560 Lantana Rd Ste 110
Lake Worth, FL 33463-6998

Mailing address

4560 Lantana Rd Ste 110
Lake Worth, FL 33463-6998
Phone (305) 266-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709002505 FL Practitioner - Nurse Practitioner 7113462631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11033620FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centrum Medical Centers Kendall, LLC CurrentSince Jan 1, 2025 Accepting new patients
Centrum Medical Holdings, LLC Current Accepting new patients
Centrum Medical Holdings, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

21073 Powerline Rd
Ste 35
Boca Raton, FL 33433
Phone (561) 489-8955

9250 NW 36th St
Ste 420
Doral, FL 33178
Phone (786) 873-1805

4560 Lantana Rd
Ste 110
Lake Worth, FL 33463
Phone (786) 953-2971

4560 Lantana Rd
Ste 101115
Lake Worth, FL 33463

7200 NW 7th St
Ste 150
Miami, FL 33126
Phone (305) 264-6270

6901 Okeechobee Blvd
Ste D7
West Palm Beach, FL 33411
Phone (561) 371-3326

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1841035128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 LANTANA RD STE 110",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334636998",
            "telephone_number": "305-266-2929",
            "fax_number": "786-558-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 LANTANA RD STE 110",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334636998",
            "telephone_number": "305-266-2929",
            "fax_number": "786-558-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ COBAS",
        "first_name": "CRISTOBAL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-27",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11033620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.