Individual
DR. JACQUELINE STEPHANIE DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9109 S US HIGHWAY 1 STE 101, PORT ST LUCIE, FL 34952-3453
(772) 398-1305
(772) 398-1307
Mailing address
PO BOX 4189, DEERFIELD BEACH, FL 33442-4189
(954) 363-9582
(954) 363-9663
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN1719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126547500
—
FL
Enumeration date
11/08/2024
Last updated
06/19/2026
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