Provider Demographics
NPI:1316546914
Name:CRUZ SOSA, VIOLETA (RBT)
Entity Type:Individual
Prefix:MRS
First Name:VIOLETA
Middle Name:
Last Name:CRUZ SOSA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14391 SW 268TH ST APT 307
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8195
Mailing Address - Country:US
Mailing Address - Phone:305-780-3296
Mailing Address - Fax:
Practice Address - Street 1:14391 SW 268TH ST APT 307
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8195
Practice Address - Country:US
Practice Address - Phone:305-780-3296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-129531106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician