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General NPI Number Information
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NPI Number | 1346949849
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Entity Type | Individual
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Provider Name | REBECA IRIZARRY LARRIUZ MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 906 N US HIGHWAY 41 STE B
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City | RUSKIN
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State | FL
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Zip | 33570-3544
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Country | US
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Telephone | 813-323-5783
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Fax |
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Provider Business Mailing Address
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Address Line | 10312 GARDEN TERRACE LN # 204B5
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City | RIVERVIEW
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State | FL
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Zip | 33578-6204
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Country | US
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Telephone | 939-717-9502
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA22357
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SZ11106
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License Number State | FL
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