Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT-15211 | FL |
NPI | 1053751982 |
---|---|
Provider Name | Veronica Alexis Cruz |
First Address | Hollywood, FL 33024-7455 |
Second Address | Hollywood, FL 33024-0000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 25/06/2013 |