Provider Demographics
NPI:1760246599
Name:LABOY, BERBELYN MICHELLE
Entity Type:Individual
Prefix:
First Name:BERBELYN
Middle Name:MICHELLE
Last Name:LABOY
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 1:6401 MAIN ST APT 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2252
Mailing Address - Country:US
Mailing Address - Phone:786-368-7894
Mailing Address - Fax:
Practice Address - Street 1:6401 MAIN ST APT 102
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2252
Practice Address - Country:US
Practice Address - Phone:786-368-7894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029572363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care