Provider Demographics
NPI:1407292170
Name:CREENCIA, JOYCE DELA CRUZ
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:DELA CRUZ
Last Name:CREENCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5940 W SAMPLE RD
Mailing Address - Street 2:APARTMENT 105
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3254
Mailing Address - Country:US
Mailing Address - Phone:954-752-6188
Mailing Address - Fax:
Practice Address - Street 1:5940 W SAMPLE RD
Practice Address - Street 2:APARTMENT 105
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-3254
Practice Address - Country:US
Practice Address - Phone:954-752-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62036264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist