MEDICARE: MRS. CASSANDRA ALYSSA 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11026735	FL

General Provider Information

NPI Number	:	1881388460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASSANDRA ALYSSA CRUZ APRN

Provider Business Mailing Address
First Line	:	6151 MIRAMAR PKWY STE 316
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3996
Country	:	US
Telephone Number	:	954-603-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 MIRAMAR PKWY STE 316&104
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3970
Country	:	US
Telephone Number	:	954-603-5100
Fax Number	:	800-816-1570

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2023
Last Update Date	:	02/20/2026

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