MEDICARE: MR. JAVIER LABRADOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1326900945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAVIER LABRADOR

Provider Business Mailing Address
First Line	:	7924 EAST DR BAY VILLAGE
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-3355
Country	:	US
Telephone Number	:	786-501-1693
Fax Number	:

Provider Business Practice Location Address
First Line	:	7924 EAST DR BAY VILLAGE
Second Line	:	302
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141
Country	:	US
Telephone Number	:	786-501-1693
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/09/2025

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