MEDICARE: ANGELA MARIA CRUZ RMHCI

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	101YM0800X	Mental Health Counselor	20308	FL

General Provider Information

NPI Number	:	1164398517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA MARIA CRUZ RMHCI

Provider Business Mailing Address
First Line	:	4346 VELEIROS AVE
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33064-2081
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2736 E OAKLAND PARK BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1605
Country	:	US
Telephone Number	:	954-900-5072
Fax Number	:

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

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	10/14/2025

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