Provider Demographics
NPI:1386629061
Name:TABANO, MARGARET E (ARNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:E
Last Name:TABANO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:E
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 863407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:1888 HILLVIEW ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3605
Practice Address - Country:US
Practice Address - Phone:941-917-8383
Practice Address - Fax:941-917-8930
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP735892363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301545900Medicaid
FLY7880OtherBCBS
FL301545900Medicaid
FLS55091Medicare UPIN