Provider Demographics
NPI:1760520688
Name:CRUZ, MARIA L (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:L
Last Name:CRUZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3853
Mailing Address - Country:US
Mailing Address - Phone:305-863-2233
Mailing Address - Fax:305-863-3296
Practice Address - Street 1:327 W 9TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3853
Practice Address - Country:US
Practice Address - Phone:305-863-2233
Practice Address - Fax:305-863-3296
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5295235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL287313OtherWELLCARE (ATA)
FL2903OtherTHC
FL4446OtherHUMANA (TRS)
FL699013OtherUHC
FLS9194OtherBCBS
FL890708100Medicaid