Provider Demographics
NPI:1851174007
Name:CRUZ MARRERO, ISABEL CRISTINA
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:CRISTINA
Last Name:CRUZ MARRERO
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 1:1295 WISPY CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-6767
Mailing Address - Country:US
Mailing Address - Phone:863-212-4520
Mailing Address - Fax:
Practice Address - Street 1:217 E OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4503
Practice Address - Country:US
Practice Address - Phone:407-219-0402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician