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NPI Code Detail

MEDICARE: MARIA E DE LA CRUZ APRN

MEDICARE: MARIA E DE LA CRUZ APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner11000482FL
2101YM0800XMental Health Counselor11000482FL
3363LP0808XPsychiatric/Mental Health Nurse Practitioner11000482FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417428095
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA E DE LA CRUZ APRN
Provider Business Mailing Address
First Line : PO BOX 3340
Second Line :
City : WINDERMERE
State : FL
Zip : 34786-3321
Country : US
Telephone Number : 407-758-6370
Fax Number :
Provider Business Practice Location Address
First Line : 200 PARK PLACE BLVD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34741-2344
Country : US
Telephone Number : 407-846-0023
Fax Number : 407-483-0378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2018
Last Update Date : 12/17/2025

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Directions to “ MARIA E DE LA CRUZ APRN” Practice Location

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