Provider Demographics
NPI:1114199619
Name:LABRADOR, EMILOU B (OT)
Entity Type:Individual
Prefix:MRS
First Name:EMILOU
Middle Name:B
Last Name:LABRADOR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:EMILOU
Other - Middle Name:B
Other - Last Name:BAUTISTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1896 PARK MEADOWS DR
Mailing Address - Street 2:LAMPLIGHT INN
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3738
Mailing Address - Country:US
Mailing Address - Phone:239-939-0382
Mailing Address - Fax:
Practice Address - Street 1:1896 PARK MEADOWS DRIVE
Practice Address - Street 2:LAMPLIGHT INN
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907
Practice Address - Country:US
Practice Address - Phone:239-939-0382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT 2183225X00000X
FLOT 13232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist