Individual
LADRECA GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12045 SW 218TH ST, MIAMI, FL 33170-2834
(786) 250-7751
Mailing address
12045 SW 218TH ST, MIAMI, FL 33170-2834
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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