Provider Demographics
NPI:1134627045
Name:CRUZ NUNEZ, IZASKUN
Entity type:Individual
Prefix:
First Name:IZASKUN
Middle Name:
Last Name:CRUZ NUNEZ
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 1:910 BAY DR APT 7
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-5636
Mailing Address - Country:US
Mailing Address - Phone:786-973-6169
Mailing Address - Fax:
Practice Address - Street 1:1228 ANASTASIA AVE APT 3
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6301
Practice Address - Country:US
Practice Address - Phone:786-973-6169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician