Provider Demographics
NPI:1710744487
Name:CRUZ, ONEIDA CELESTE
Entity Type:Individual
Prefix:
First Name:ONEIDA
Middle Name:CELESTE
Last Name:CRUZ
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 1:3615 MISTY OAK DR APT 405
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-8704
Mailing Address - Country:US
Mailing Address - Phone:830-279-4996
Mailing Address - Fax:
Practice Address - Street 1:3615 MISTY OAK DR APT 405
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-8704
Practice Address - Country:US
Practice Address - Phone:830-279-4996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker