Healthcare Provider Details

I. General information

NPI: 1922585496
Provider Name (Legal Business Name): LAILA NICOLE HABIB PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 OCOEE APOPKA RD
APOPKA FL
32703-9210
US

IV. Provider business mailing address

2006 SANDY GARDEN LN
WINTER GARDEN FL
34787-9385
US

V. Phone/Fax

Practice location:
  • Phone: 407-652-7026
  • Fax: 407-652-7027
Mailing address:
  • Phone: 352-988-4324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9111509
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: