Provider Demographics
NPI:1083453500
Name:GOMEZ CRUZ, ORIANA (RBT-24-346590)
Entity type:Individual
Prefix:
First Name:ORIANA
Middle Name:
Last Name:GOMEZ CRUZ
Suffix:
Gender:F
Credentials:RBT-24-346590
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 HIDDEN SHADOW DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1467
Mailing Address - Country:US
Mailing Address - Phone:813-898-3645
Mailing Address - Fax:
Practice Address - Street 1:4529 HIDDEN SHADOW DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1467
Practice Address - Country:US
Practice Address - Phone:813-898-3645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-346590106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician