Provider Demographics
NPI:1235358789
Name:DECAROLIS, MARGARET (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:DECAROLIS
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1118 GULF BREEZE PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-7800
Mailing Address - Country:US
Mailing Address - Phone:850-748-6688
Mailing Address - Fax:850-916-1794
Practice Address - Street 1:1118 GULF BREEZE PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-7800
Practice Address - Country:US
Practice Address - Phone:850-748-6688
Practice Address - Fax:850-916-1794
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP936099363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health