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Individual

AVELITA DELA CRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7105 50TH AVE N, ST PETERSBURG, FL 33709-2701
(727) 674-5063
Mailing address
7105 50TH AVE N, ST PETERSBURG, FL 33709-2701
(727) 674-5063

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
1244461
FL
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
691998796
FL
Enumeration date
10/25/2021
Last updated
11/29/2021
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