MEDICARE: LABOY OSTEOPATHIC PL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	OS11253	FL

General Provider Information

NPI Number	:	1225377567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABOY OSTEOPATHIC PL

Provider Business Mailing Address
First Line	:	110 S 10TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-1534
Country	:	US
Telephone Number	:	954-566-5097
Fax Number	:	954-566-2037

Provider Business Practice Location Address
First Line	:	2717 E OAKLAND PARK BLVD
Second Line	:	SUITE 103
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1664
Country	:	US
Telephone Number	:	954-566-5097
Fax Number	:	954-566-2037

Authorized Official
Title or Position	:	CEO
Name	:	FRANCISCO LABOY III
Credential	:	DO
Telephone Number	:	609-238-0516

Provider Enumeration Date	:	02/06/2013
Last Update Date	:	02/06/2013

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