Provider Demographics
NPI:1477352110
Name:KHOURI LABBAD, PEGGY LOURDES (FNP-C)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:LOURDES
Last Name:KHOURI LABBAD
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2372 SANTA VISTA LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-9251
Mailing Address - Country:US
Mailing Address - Phone:407-881-6517
Mailing Address - Fax:
Practice Address - Street 1:3160 SOUTHGATE COMMERCE BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-8549
Practice Address - Country:US
Practice Address - Phone:407-423-5178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038174363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily