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General NPI Number Information
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NPI Number | 1639524515
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Entity Type | Individual
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Provider Name | MAILYN CRUZ CBHCMS
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Gender | Female
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 2500 E HALLANDALE BEACH BLVD STE 802
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4841
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Country | US
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Telephone | 786-322-0862
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 E HALLANDALE BEACH BLVD STE 802
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4841
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Country | US
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Telephone | 786-322-0862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | CBHCMS100013
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License Number State | FL
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