MEDICARE: VANESA CRUZ OTR

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	225X00000X	Occupational Therapist	OT20811	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1720697899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESA CRUZ OTR

Provider Business Mailing Address
First Line	:	4360 SW 97TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-5151
Country	:	US
Telephone Number	:	305-721-5405
Fax Number	:

Provider Business Practice Location Address
First Line	:	4360 SW 97TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-5151
Country	:	US
Telephone Number	:	305-721-5405
Fax Number	:

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

Provider Enumeration Date	:	07/24/2020
Last Update Date	:	07/24/2020

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Directions to “ VANESA CRUZ OTR” Practice Location

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