Provider Demographics
NPI:1578927331
Name:CRUZ, DAMILKA (OTR/L)
Entity Type:Individual
Prefix:
First Name:DAMILKA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-2303
Mailing Address - Country:US
Mailing Address - Phone:786-975-3967
Mailing Address - Fax:
Practice Address - Street 1:2051 NW 112TH AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-1828
Practice Address - Country:US
Practice Address - Phone:305-477-7808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17720225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics