Provider Demographics
NPI:1083079495
Name:LABELLA, JOSEPH AMERICO
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:AMERICO
Last Name:LABELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541224
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32954-1224
Mailing Address - Country:US
Mailing Address - Phone:321-403-7113
Mailing Address - Fax:321-452-1385
Practice Address - Street 1:1460 PARADISE CT
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-5560
Practice Address - Country:US
Practice Address - Phone:321-403-7113
Practice Address - Fax:321-452-1385
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234010253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care