Healthcare Provider Details

I. General information

NPI: 1679486344
Provider Name (Legal Business Name): IRINIA RODRIGUEZ LABRADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4442 5HT ST W
BRADENTON FL
34207
US

IV. Provider business mailing address

5428 8TH STREET CT W
BRADENTON FL
34207-3303
US

V. Phone/Fax

Practice location:
  • Phone: 941-744-1211
  • Fax:
Mailing address:
  • Phone: 941-744-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-534931
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: