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General NPI Number Information
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NPI Number | 1750189239
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Entity Type | Individual
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Provider Name | MARIAM IBRAHIM LABIB OD
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Gender | Female
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 13904 N DALE MABRY HWY
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City | TAMPA
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State | FL
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Zip | 33618-2446
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Country | US
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Telephone | 813-908-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 35 CAROLWOOD CRES
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City | MARKHAM
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State | ONTARIO
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Zip | L3S4T2
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Country | CA
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | XXXXXXXX
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License Number State | FL
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