Provider Demographics
NPI:1003658519
Name:CRUZ NAVES, DIANELYS
Entity type:Individual
Prefix:
First Name:DIANELYS
Middle Name:
Last Name:CRUZ NAVES
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 1:1345 NW 84TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4337
Mailing Address - Country:US
Mailing Address - Phone:786-354-5937
Mailing Address - Fax:
Practice Address - Street 1:1345 NW 84TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4337
Practice Address - Country:US
Practice Address - Phone:786-354-5937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-348676106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician