Provider Demographics
NPI:1376225029
Name:CRUZ LEON, MAIBELYS (RBT-23-287450)
Entity Type:Individual
Prefix:
First Name:MAIBELYS
Middle Name:
Last Name:CRUZ LEON
Suffix:
Gender:F
Credentials:RBT-23-287450
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 NW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-6533
Mailing Address - Country:US
Mailing Address - Phone:786-560-6607
Mailing Address - Fax:
Practice Address - Street 1:2430 NW 26TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6533
Practice Address - Country:US
Practice Address - Phone:786-560-6607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-287450106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician