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NPI Code Detail

MEDICARE: ROSA NILA LORENZO CRUZ RBT

MEDICARE:   ROSA NILA LORENZO CRUZ  RBT
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
1106S00000XBehavior TechnicianRBT-22-240554FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215654488
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSA NILA LORENZO CRUZ RBT
Provider Business Mailing Address
First Line : 6423 ROYAL HUNT DR APT 101
Second Line :
City : TAMPA
State : FL
Zip : 33625-2496
Country : US
Telephone Number : 813-500-1312
Fax Number :
Provider Business Practice Location Address
First Line : 6702 N GUNLOCK AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-4508
Country : US
Telephone Number : 813-644-5766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2022
Last Update Date : 10/27/2022

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Directions to “ ROSA NILA LORENZO CRUZ RBT” Practice Location

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