Provider Demographics
NPI:1619635083
Name:MENDEZ-LABRADA, LAIZA BARBARA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LAIZA
Middle Name:BARBARA
Last Name:MENDEZ-LABRADA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15675 SW 9TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2430
Mailing Address - Country:US
Mailing Address - Phone:305-216-0247
Mailing Address - Fax:
Practice Address - Street 1:5860 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3363
Practice Address - Country:US
Practice Address - Phone:305-264-7808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11016863363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health