Provider Demographics
NPI:1063720316
Name:LABIB, WAEL A (PT)
Entity type:Individual
Prefix:MR
First Name:WAEL
Middle Name:A
Last Name:LABIB
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 20TH STREET
Mailing Address - Street 2:
Mailing Address - City:BELLEAIR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33786
Mailing Address - Country:US
Mailing Address - Phone:727-504-2905
Mailing Address - Fax:
Practice Address - Street 1:101 20TH STREET
Practice Address - Street 2:
Practice Address - City:BELLEAIR BEACH
Practice Address - State:FL
Practice Address - Zip Code:33786
Practice Address - Country:US
Practice Address - Phone:727-504-2905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist