Provider Demographics
NPI:1033376652
Name:QUILTY, MARGARET O
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:O
Last Name:QUILTY
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 1:1735 FLAMINGO DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1910
Mailing Address - Country:US
Mailing Address - Phone:407-896-4847
Mailing Address - Fax:407-894-2249
Practice Address - Street 1:1735 FLAMINGO DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1910
Practice Address - Country:US
Practice Address - Phone:407-896-4847
Practice Address - Fax:407-894-2249
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL230050800Medicaid