MEDICARE: DR. MIGUEL LABRADA PT, DPT, PTA

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	2251X0800X	Orthopedic Physical Therapist	PT33901	FL

General Provider Information

NPI Number	:	1619417656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIGUEL LABRADA PT, DPT, PTA

Provider Business Mailing Address
First Line	:	4109 N ARMENIA AVE STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6411
Country	:	US
Telephone Number	:	813-588-3342
Fax Number	:	813-588-3602

Provider Business Practice Location Address
First Line	:	4109 N ARMENIA AVE STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6411
Country	:	US
Telephone Number	:	813-588-3342
Fax Number	:	813-588-3602

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2017
Last Update Date	:	04/22/2024

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