Provider Demographics
NPI:1417932344
Name:ARGUELLO, MARIA L (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:L
Last Name:ARGUELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:L
Other - Last Name:ARUELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:100 NORTH STATE RD 7
Mailing Address - Street 2:SUITE # 201B
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063
Mailing Address - Country:US
Mailing Address - Phone:954-933-9090
Mailing Address - Fax:954-933-9092
Practice Address - Street 1:100 NORTH STATE RD 7
Practice Address - Street 2:SUITE # 301B
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063
Practice Address - Country:US
Practice Address - Phone:954-933-9090
Practice Address - Fax:954-933-9092
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259667900Medicaid
FLK3639Medicare ID - Type Unspecified
FL83113YMedicare PIN
FLG62379Medicare UPIN
FL259667900Medicaid