MEDICARE: MS. BEATRIZ D CRUZ LCSW

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	1041C0700X	Clinical Social Worker	SW16149	FL

General Provider Information

NPI Number	:	1093365314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BEATRIZ D CRUZ LCSW

Provider Business Mailing Address
First Line	:	1057 NE 210 TERRACE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179
Country	:	US
Telephone Number	:	305-494-8835
Fax Number	:

Provider Business Practice Location Address
First Line	:	MIAMI BEACH CHC - NORTH MIAMI CENTER
Second Line	:	11645 BISCAYNE BLVD STE 408
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-3148
Country	:	US
Telephone Number	:	305-538-8835
Fax Number	:

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

Provider Enumeration Date	:	09/18/2019
Last Update Date	:	09/18/2019

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