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NPI Code Detail

MEDICARE: ELIZABETH CRUZ

MEDICARE: ELIZABETH 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
1106S00000XBehavior Technician

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 : 1770214017
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH CRUZ
Provider Business Mailing Address
First Line : 9600 ELAN CIR APT 302
Second Line :
City : ORLANDO
State : FL
Zip : 32836-7067
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2132 CENTRAL FLORIDA PKWY STE C1
Second Line :
City : ORLANDO
State : FL
Zip : 32837-8978
Country : US
Telephone Number : 407-674-7670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2022
Last Update Date : 06/17/2022

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