Jennifer Yvonne Cruz

Individual provider Active NPI Behavior Technician · Goulds, FL

NPI 1780128371 · NPPES record last updated May 21, 2019

Key facts

NPI
1780128371
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
11276 SW 232ND St
Goulds, FL 33170-7505
Phone
(305) 912-8399
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

11276 SW 232ND St
Goulds, FL 33170-7505

Mailing address

30660 SW 188TH Ave
Homestead, FL 33030-3834
Phone (305) 761-6459

Other providers in Goulds, FL

All providers in Goulds, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.