Individual
FADY LABIB-IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(855) 979-5700
(855) 979-5701
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
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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