MEDICARE: RODRIGO CRUZ

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	106S00000X	Behavior Technician		OR

General Provider Information

NPI Number	:	1033072418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODRIGO CRUZ

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	4409 FRIEDA AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-3829
Country	:	US
Telephone Number	:	541-880-3569
Fax Number	:	541-880-3569

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

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “ RODRIGO CRUZ ” Practice Location

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