1053357913 NPI number — ANDREW S LABBIE MD

Table of content: ANDREW S LABBIE MD (NPI 1053357913)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053357913 NPI number — ANDREW S LABBIE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LABBIE
Provider First Name:
ANDREW
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053357913
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 277279
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-7279
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-243-3839
Provider Business Mailing Address Fax Number:
855-527-5510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3200 SW 60TH CT STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33155-4069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-669-6448
Provider Business Practice Location Address Fax Number:
305-663-8485
Provider Enumeration Date:
06/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2088P0231X , with the licence number:  ME55737 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000853 . This is a "NEIGHBORHOOD HEALTH PARTNERSHIP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 061671100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7911585 . This is a "GHI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 151912 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 151912 . This is a "STAYWELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 54415 . This is a "SCFN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 015080 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 09409 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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