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General NPI Number Information
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NPI Number | 1659754919
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Entity Type | Individual
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Provider Name | FREDERICK NELSON LABORDE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2015
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Last Update Date | 03/16/2024
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Provider Practice Location Address
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Address Line | 3333 W COMMERCIAL BLVD STE 110
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3407
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Country | US
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Telephone | 954-530-9770
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Fax |
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Provider Business Mailing Address
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Address Line | 14240 JOCKEY CIR S
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City | DAVIE
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State | FL
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Zip | 33330-1062
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Country | US
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Telephone | 516-589-9386
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME134721
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License Number State | FL
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