MEDICARE: DR. KIRSTIN LABELL MD

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	207Q00000X	Family Medicine Physician	ME138589	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891220489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRSTIN LABELL MD

Provider Business Mailing Address
First Line	:	145 CITY PL
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-2479
Country	:	US
Telephone Number	:	386-302-0975
Fax Number	:	386-302-0976

Provider Business Practice Location Address
First Line	:	145 CITY PL
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-2479
Country	:	US
Telephone Number	:	386-302-0975
Fax Number	:	386-302-0976

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

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	05/15/2023

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