Provider Demographics
NPI:1578185070
Name:LABRADA ARZUAGA, YAMILIA
Entity Type:Individual
Prefix:
First Name:YAMILIA
Middle Name:
Last Name:LABRADA ARZUAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 SW 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4731
Mailing Address - Country:US
Mailing Address - Phone:786-356-5254
Mailing Address - Fax:
Practice Address - Street 1:1224 SW 30TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4731
Practice Address - Country:US
Practice Address - Phone:786-356-5254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-116983106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician