Provider Demographics
NPI:1902679707
Name:CRUZ MILAN, DAILYN
Entity type:Individual
Prefix:
First Name:DAILYN
Middle Name:
Last Name:CRUZ MILAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NW 112TH AVE APT 702
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4198
Mailing Address - Country:US
Mailing Address - Phone:786-352-0653
Mailing Address - Fax:
Practice Address - Street 1:7762 VENETIAN ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-2444
Practice Address - Country:US
Practice Address - Phone:321-346-8450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL120477200Medicaid