Basic Information
| Provider Information | |||||||||
| NPI: | 1053871202 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LABRADA LABRADA | ||||||||
| FirstName: | LISBETH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5918 SW 133RD PL | ||||||||
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| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331835102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059843950 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 BLYTHE BLVD FL 4 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282035812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043816800 | ||||||||
| FaxNumber: | 7043816841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2019 | ||||||||
| LastUpdateDate: | 03/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 250310 | NC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.