Provider Demographics
NPI:1972670123
Name:LABRADA, LIUDMILA (DMD,PA)
Entity Type:Individual
Prefix:
First Name:LIUDMILA
Middle Name:
Last Name:LABRADA
Suffix:
Gender:F
Credentials:DMD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15525 BULL RUN RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7004
Mailing Address - Country:US
Mailing Address - Phone:305-231-1820
Mailing Address - Fax:305-231-1838
Practice Address - Street 1:15525 BULL RUN RD
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7004
Practice Address - Country:US
Practice Address - Phone:305-231-1820
Practice Address - Fax:305-231-1838
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 155731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice