Provider Demographics
NPI:1245040690
Name:NAVEIRA CRUZ, MAIDELYS
Entity type:Individual
Prefix:
First Name:MAIDELYS
Middle Name:
Last Name:NAVEIRA CRUZ
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 1:771 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3663
Mailing Address - Country:US
Mailing Address - Phone:580-571-1238
Mailing Address - Fax:
Practice Address - Street 1:5985 W 25TH CT STE 108
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-4462
Practice Address - Country:US
Practice Address - Phone:786-269-6163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32758225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant