MEDICARE: LEIDYS C ESTRADA 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	RBT-25-498867	FL

General Provider Information

NPI Number	:	1174481568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIDYS C ESTRADA CRUZ

Provider Business Mailing Address
First Line	:	3726 W IDLEWILD CIR APT 235
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5761
Country	:	US
Telephone Number	:	509-491-7015
Fax Number	:

Provider Business Practice Location Address
First Line	:	3726 W IDLEWILD CIR APT 235
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5761
Country	:	US
Telephone Number	:	509-491-7015
Fax Number	:

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ LEIDYS C ESTRADA CRUZ ” Practice Location

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