| NPI | 1518634054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRAINELYS CRUZ Provider 321-278-4084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-10-21 |