MEDICARE: JANY HERNANDEZ 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-25-489771	FL

General Provider Information

NPI Number	:	1184588709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANY HERNANDEZ CRUZ

Provider Business Mailing Address
First Line	:	1275 7TH AVE N APT 206
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-5657
Country	:	US
Telephone Number	:	239-778-8455
Fax Number	:	239-977-3644

Provider Business Practice Location Address
First Line	:	5425 GOLDEN GATE PKWY
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34116-7524
Country	:	US
Telephone Number	:	239-778-8455
Fax Number	:	239-977-3644

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/12/2025

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