Healthcare Provider Details

I. General information

NPI: 1528923968
Provider Name (Legal Business Name): MS. ISABELA SOL LARACUENTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 WESTON RD STE 100
WESTON FL
33331-3638
US

IV. Provider business mailing address

10892 NW 8TH ST
PEMBROKE PINES FL
33026-4054
US

V. Phone/Fax

Practice location:
  • Phone: 888-258-4941
  • Fax: 954-416-7373
Mailing address:
  • Phone: 786-915-1273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-468854
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: