Provider Demographics
NPI:1275718843
Name:LALOR, MARGARET LILLIAN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:LILLIAN
Last Name:LALOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:PEGGI
Other - Middle Name:LILLIAN
Other - Last Name:LALOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:1700 66TH ST. N.
Mailing Address - Street 2:SUITE 510
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-5512
Mailing Address - Country:US
Mailing Address - Phone:727-384-2479
Mailing Address - Fax:727-384-3573
Practice Address - Street 1:1700 66TH ST. N.
Practice Address - Street 2:SUITE 510
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-5512
Practice Address - Country:US
Practice Address - Phone:727-384-2479
Practice Address - Fax:727-384-3573
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2711732363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008755800Medicaid
FL008755800Medicaid