Individual
FADY LABIB-IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106197
FL
363AM0700X
Medical Physician Assistant
PA9106197
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101352300
—
FL
01
—
Y09TB
BCBS
FL
Enumeration date
10/14/2011
Last updated
01/03/2024
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