Provider Demographics
NPI:1447602289
Name:LABARGA, MARIA LUISA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LUISA
Last Name:LABARGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1609
Mailing Address - Country:US
Mailing Address - Phone:954-990-2050
Mailing Address - Fax:
Practice Address - Street 1:600 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1609
Practice Address - Country:US
Practice Address - Phone:954-990-2050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53416174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist