| Ladebe Llc | |
|
804 Richland Ave Lafayette LA 70508-6661 | |
| (337) 291-2455 | |
| Not Available |
| Full Name | Ladebe Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 804 Richland Ave, Lafayette, Louisiana |
| Authorized Official Name and Position | Federico Deltoro (PHYSICIAN) |
| Authorized Official Contact | 3372885557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ladebe Llc Po Box 81736 Lafayette LA 70598-1736 Ph: (337) 291-2455 | Ladebe Llc 804 Richland Ave Lafayette LA 70508-6661 Ph: (337) 291-2455 |
| NPI Number | 1821216144 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 05/10/2012 |
| Medicare PECOS PAC ID | 9335302017 |
|---|---|
| Medicare Enrollment ID | O20120516000180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821216144 | NPI | - | NPPES |
| 1444855 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Secondary |
| Provider Name | Maximo B Lamarche |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1003852567 PECOS PAC ID: 3678481215 Enrollment ID: I20060313000073 |
| Provider Name | Federico Del Toro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932118445 PECOS PAC ID: 0840245338 Enrollment ID: I20100814000052 |
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