Provider Demographics
NPI:1306015243
Name:LABROUSSE, LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:
Last Name:LABROUSSE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8411 BISCAYNE BLVD
Mailing Address - Street 2:FRONT OFFICE
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3522
Mailing Address - Country:US
Mailing Address - Phone:305-757-5117
Mailing Address - Fax:305-751-0497
Practice Address - Street 1:8411 BISCAYNE BLVD
Practice Address - Street 2:FRONT OFFICE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-3522
Practice Address - Country:US
Practice Address - Phone:305-757-5117
Practice Address - Fax:305-751-0497
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381607900Medicaid