Provider Demographics
NPI:1154500361
Name:WARDLAW, MARGARET GREEN (CNM)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:GREEN
Last Name:WARDLAW
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:MARY
Other - Last Name:GREEN WARDLAW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:8700 N KENDALL DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2206
Mailing Address - Country:US
Mailing Address - Phone:305-274-3130
Mailing Address - Fax:
Practice Address - Street 1:8700 N KENDALL DR
Practice Address - Street 2:SUITE 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2206
Practice Address - Country:US
Practice Address - Phone:305-274-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9348053367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD719LN028Medicare PIN