Active NPI
Tamara D Edwards-Cruz, BUSINESS OWNER
- Driver
- Jacksonville, FL
National Provider Identifier
1881377752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- E363804748750
- Practice address
- 2489 W 30TH St
Jacksonville, FL 32209-3407 - Phone
- (904) 607-6124
- NPI assigned
- Aug 8, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | E363804748750 | FL | Primary |
Addresses
Primary practice location
2489 W 30TH St
Jacksonville, FL 32209-3407
Mailing address
6001 Argyle Forest Blvd
Ste21 #153
Jacksonville, FL 32244
Phone (904) 861-6686
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 |
|---|---|---|---|
| E363804748750 | FL | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691452800000",
"number": "1881377752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6001 ARGYLE FOREST BLVD",
"address_2": "STE21 #153",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32244",
"telephone_number": "904-861-6686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2489 W 30TH ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322093407",
"telephone_number": "904-607-6124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS-CRUZ",
"first_name": "TAMARA",
"middle_name": "D",
"credential": "BUSINESS OWNER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-08",
"last_updated": "2023-08-08",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "FL",
"license": "E363804748750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.