Provider Demographics
NPI:1831636992
Name:CRUZADO, NAYDETTE MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:NAYDETTE
Middle Name:MARIE
Last Name:CRUZADO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C6 CALLE PROFETA APT 2621
Mailing Address - Street 2:URB VALLE ENCANTADO
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-346-3068
Mailing Address - Fax:
Practice Address - Street 1:C6 CALLE PROFETA APT 2621
Practice Address - Street 2:URB VALLE ENCANTADO
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-346-3068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist