Provider Demographics
NPI:1396503835
Name:CRUZATA MILA, LILIBET
Entity type:Individual
Prefix:
First Name:LILIBET
Middle Name:
Last Name:CRUZATA MILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 W 41ST ST APT D
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5923
Mailing Address - Country:US
Mailing Address - Phone:786-956-4069
Mailing Address - Fax:
Practice Address - Street 1:1445 W 41ST ST APT D
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5923
Practice Address - Country:US
Practice Address - Phone:786-956-4069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician