Provider Demographics
NPI:1407522188
Name:GUERRA LABRADA, OBEYDA
Entity Type:Individual
Prefix:
First Name:OBEYDA
Middle Name:
Last Name:GUERRA LABRADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8180 NW 36TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6653
Mailing Address - Country:US
Mailing Address - Phone:786-334-6946
Mailing Address - Fax:786-313-3079
Practice Address - Street 1:8180 NW 36TH ST STE 209
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6653
Practice Address - Country:US
Practice Address - Phone:786-334-6946
Practice Address - Fax:786-313-3079
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator