Provider Demographics
NPI:1871481432
Name:LABRA HERNANDEZ, JESUS
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:LABRA HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SW 30TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1251
Mailing Address - Country:US
Mailing Address - Phone:786-942-8338
Mailing Address - Fax:
Practice Address - Street 1:70 SW 30TH AVE APT 1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1251
Practice Address - Country:US
Practice Address - Phone:786-942-8338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist