Provider Demographics
NPI:1124452339
Name:DE LA TORRE CRUZ, JOEL LAZARO (APRN)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:LAZARO
Last Name:DE LA TORRE CRUZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14311 SW 88TH ST APT A208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8078
Mailing Address - Country:US
Mailing Address - Phone:305-926-5674
Mailing Address - Fax:
Practice Address - Street 1:9804 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3912
Practice Address - Country:US
Practice Address - Phone:305-222-9154
Practice Address - Fax:305-222-9155
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator