MEDICARE: ELIZABETH LARRINAGA RBT

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	103K00000X	Behavior Analyst	1-25-86824	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437638806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LARRINAGA RBT

Provider Business Mailing Address
First Line	:	10850 S US HIGHWAY 1 STE 2
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-6407
Country	:	US
Telephone Number	:	305-776-7886
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 SW FRIAR ST
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-1817
Country	:	US
Telephone Number	:	305-776-7886
Fax Number	:

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

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	01/09/2026

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