Provider Demographics
NPI:1457680274
Name:DE LA CRUZ, EDUARDO (MS)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:DE LA CRUZ
Suffix:
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:EDUARDO
Other - Middle Name:
Other - Last Name:DE LA CRUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:445 NW 4TH ST APT 1305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33128-1716
Mailing Address - Country:US
Mailing Address - Phone:786-281-2052
Mailing Address - Fax:
Practice Address - Street 1:445 NW 4TH ST APT 415
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1702
Practice Address - Country:US
Practice Address - Phone:786-281-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist