Provider Demographics
NPI:1467827998
Name:SANINOCENCIO-CRUZ, MILAGROS
Entity type:Individual
Prefix:
First Name:MILAGROS
Middle Name:
Last Name:SANINOCENCIO-CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MILLIE
Other - Middle Name:
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4487 FOXCHASE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-8201
Mailing Address - Country:US
Mailing Address - Phone:407-692-8817
Mailing Address - Fax:
Practice Address - Street 1:801 DOUGLAS AVE
Practice Address - Street 2:208
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5206
Practice Address - Country:US
Practice Address - Phone:407-830-6412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FLS552-540-65-821-0101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor