Healthcare Provider Details

I. General information

NPI: 1336063643
Provider Name (Legal Business Name): YANAYSI CRUZ FNP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15945 SW 240TH ST
HOMESTEAD FL
33031-1334
US

IV. Provider business mailing address

15945 SW 240TH ST
HOMESTEAD FL
33031-1334
US

V. Phone/Fax

Practice location:
  • Phone: 786-443-0921
  • Fax:
Mailing address:
  • Phone: 786-443-0921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YANAYSI CRUZ
Title or Position: PRESIDENT
Credential: NP
Phone: 786-443-0921