MEDICARE: ADALYRIS RAMOS 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

General Provider Information

NPI Number	:	1891512885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADALYRIS RAMOS CRUZ

Provider Business Mailing Address
First Line	:	8610 HIDDEN RIVER PKWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33637-1152
Country	:	US
Telephone Number	:	813-841-9662
Fax Number	:	813-704-2600

Provider Business Practice Location Address
First Line	:	8610 HIDDEN RIVER PKWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33637-1152
Country	:	US
Telephone Number	:	813-841-9662
Fax Number	:	813-704-2600

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

Provider Enumeration Date	:	09/23/2024
Last Update Date	:	09/23/2024

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Directions to “ ADALYRIS RAMOS CRUZ ” Practice Location

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