MEDICARE: JALENE 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		FL

General Provider Information

NPI Number	:	1154275709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JALENE CRUZ

Provider Business Mailing Address
First Line	:	4309 AVALON SUITES TER APT A404B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4661
Country	:	US
Telephone Number	:	917-640-4218
Fax Number	:

Provider Business Practice Location Address
First Line	:	4309 AVALON SUITES TER APT A404B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4661
Country	:	US
Telephone Number	:	917-640-4218
Fax Number	:

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

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/23/2026

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Directions to “ JALENE CRUZ ” Practice Location

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