Active NPI
Gretell De Jesus Cruz
- Behavior Technician
- Doral, FL
National Provider Identifier
1538741038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- C620-284-02-850-0
- Practice address
- 7875 NW 12TH St Ste 109
Doral, FL 33126-1815 - Phone
- (786) 269-3502
- NPI assigned
- Apr 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | C620-284-02-850-0 | FL | Primary |
Addresses
Primary practice location
7875 NW 12TH St Ste 109
Doral, FL 33126-1815
Mailing address
9030 SW 27TH St
Miami, FL 33165-3208
Phone (786) 779-6909
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crystal Minds Psychological Services | Current | Accepting new patients | |
| Lacosta Therapy, LLC | Past | Accepting new patients |
Locations
7875 NW 12th St
Ste 109
Doral, FL 33126
Phone (786) 269-3502
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Doral, FL
- NPI 1316408180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619136000000",
"number": "1538741038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9030 SW 27TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331653208",
"telephone_number": "786-779-6909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7875 NW 12TH ST STE 109",
"city": "DORAL",
"state": "FL",
"postal_code": "331261815",
"telephone_number": "786-269-3502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "GRETELL",
"middle_name": "DE JESUS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-23",
"last_updated": "2021-04-23",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "C620-284-02-850-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Doral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.