Healthcare Provider Details

I. General information

NPI: 1861328759
Provider Name (Legal Business Name): LEIDYS JULIA ALFONSO DE LA CRUZ ARNP, MSN-FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2469 W 78TH ST APT 101
HIALEAH FL
33016-2823
US

IV. Provider business mailing address

2469 W 78TH ST APT 101
HIALEAH FL
33016-2823
US

V. Phone/Fax

Practice location:
  • Phone: 786-641-1217
  • Fax:
Mailing address:
  • Phone: 786-641-1217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN9661948
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: