Provider Demographics
NPI:1093860074
Name:LYONS, MARGARITA L (PA-C)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:L
Last Name:LYONS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 US HIGHWAY 1
Mailing Address - Street 2:STE 2
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-4600
Mailing Address - Country:US
Mailing Address - Phone:561-775-6455
Mailing Address - Fax:
Practice Address - Street 1:649 US HIGHWAY 1
Practice Address - Street 2:STE 2
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-4600
Practice Address - Country:US
Practice Address - Phone:561-775-6455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01720363A00000X
FLPA9104852363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S33763Medicare UPIN
S33763Medicare UPIN