Provider Demographics
NPI:1902187297
Name:LABIAL, GUILLERMO RUBIO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:RUBIO
Last Name:LABIAL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 LAS NAVAS PL
Mailing Address - Street 2:NONE
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-0606
Mailing Address - Country:US
Mailing Address - Phone:904-238-1009
Mailing Address - Fax:
Practice Address - Street 1:945 LAS NAVAS PL
Practice Address - Street 2:NONE
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-0606
Practice Address - Country:US
Practice Address - Phone:904-238-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 24006251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health