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Individual

MS. THERESA MAE LABRECQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, PA-C

Contact information

Practice address
1921 WALDEMERE ST STE 401, SARASOTA, FL 34239-2941
(941) 261-1400
(941) 308-8420
Mailing address
PO BOX 947407, ATLANTA, GA 30394-7407
(941) 917-2600
(941) 917-7884

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
1076651
MA
363AS0400X
Surgical Physician Assistant
Primary
PA9115370
FL

Other

Enumeration date
12/03/2007
Last updated
12/23/2021
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