Provider Demographics
NPI:1164175626
Name:MOTT, MARGARET (LPN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MOTT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 W WARREN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4036
Mailing Address - Country:US
Mailing Address - Phone:407-214-9019
Mailing Address - Fax:407-830-0664
Practice Address - Street 1:651 W WARREN AVE STE 100
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4036
Practice Address - Country:US
Practice Address - Phone:407-214-9019
Practice Address - Fax:407-830-0664
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5193592164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse