Jacobo a Cruz MD PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME48974 Issued in FL

Legal business name

JACOBO A CRUZ MD PA

Practice address

4400 Bayou Blvd
Suite 51
Pensacola, FL 32503-2673

Phone

(850) 484-7774

Fax

(850) 484-8874

NPI assigned

Aug 7, 2008

Last updated

Sep 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacobo A Cruz, MDNPI 1043301518

Title

President

Phone

(850) 484-7774

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jacobo A Cruz MD Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacobo A. Cruz, M.D.

  • Psychiatry Physician
  • Pensacola, FL
  • NPI 1043301518
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1952557183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD",
            "address_2": "SUITE 51",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032673",
            "telephone_number": "850-484-7774",
            "fax_number": "850-484-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD",
            "address_2": "SUITE 51",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032673",
            "telephone_number": "850-484-7774",
            "fax_number": "850-484-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOBO A CRUZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "JACOBO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-484-7774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME48974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048405900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043301518",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacobo A Cruz MD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Shelby Jackson
• Steven L Jackson, R.PH.
• Tamara M Jackson, LMT
• Jacksonville Emergency Consultants
• Sara Elisabeth Jacobi, PTA
• Ashley Jacobs, MS, RD, LD
• Maria-Flora Jacobs, D.M.D
• Michael Matthew Jacobs, M.D., M.P.H.
• Misty Lane Jacobs
• Brenda A Jacobsen, D.O.

• Psychiatry Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.