Provider Demographics
NPI:1144104860
Name:LABRANCHE, MIMOSE
Entity type:Individual
Prefix:
First Name:MIMOSE
Middle Name:
Last Name:LABRANCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 LANTANA RD STE A3
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6997
Mailing Address - Country:US
Mailing Address - Phone:561-385-3554
Mailing Address - Fax:
Practice Address - Street 1:4550 LANTANA RD STE A3
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-6997
Practice Address - Country:US
Practice Address - Phone:561-385-3554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health