Provider Demographics
NPI:1265074397
Name:MEDERAPY HEALTH GROUP
Entity type:Organization
Organization Name:MEDERAPY HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:LABRADA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:305-772-1052
Mailing Address - Street 1:6424 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-5712
Mailing Address - Country:US
Mailing Address - Phone:305-804-1200
Mailing Address - Fax:
Practice Address - Street 1:6424 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5712
Practice Address - Country:US
Practice Address - Phone:305-804-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT33901OtherPT33901