Provider Demographics
NPI:1396228342
Name:ABANADOR, MARJORIE PANCHO (ARNP)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:PANCHO
Last Name:ABANADOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:LOZADA
Other - Last Name:PANCHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:5772 LAUREL CHERRY AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-6409
Mailing Address - Country:US
Mailing Address - Phone:407-353-9144
Mailing Address - Fax:
Practice Address - Street 1:5772 LAUREL CHERRY AVE
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-6409
Practice Address - Country:US
Practice Address - Phone:407-353-9144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9290907363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily