Provider Demographics
NPI:1770891020
Name:MANZANILLA LUBERTI, LAURA E (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:E
Last Name:MANZANILLA LUBERTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2102 TREASURE HILLS BLVD # 3.14406
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8736
Mailing Address - Country:US
Mailing Address - Phone:956-296-1437
Mailing Address - Fax:956-296-6842
Practice Address - Street 1:3804 S JACKSON RD STE 2
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6682
Practice Address - Country:US
Practice Address - Phone:956-296-3021
Practice Address - Fax:956-296-3020
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01072298A207Q00000X
TXR5891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty