Provider Demographics
NPI:1265104236
Name:CUZA MATIAS, ABELARDO
Entity type:Individual
Prefix:
First Name:ABELARDO
Middle Name:
Last Name:CUZA MATIAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9863 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2385
Mailing Address - Country:US
Mailing Address - Phone:561-674-8463
Mailing Address - Fax:
Practice Address - Street 1:9863 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2385
Practice Address - Country:US
Practice Address - Phone:561-674-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2023-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician