MEDICARE: HECTOR LABRADA M.D.

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	208D00000X	General Practice Physician	ME68564	FL

General Provider Information

NPI Number	:	1700862414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HECTOR LABRADA M.D.

Provider Business Mailing Address
First Line	:	5810 SW 16TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-2105
Country	:	US
Telephone Number	:	305-261-8127
Fax Number	:	786-353-2163

Provider Business Practice Location Address
First Line	:	5810 SW 16TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-2105
Country	:	US
Telephone Number	:	305-261-8127
Fax Number	:	786-353-2163

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	11/07/2019

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