Provider Demographics
NPI:1619011772
Name:MOFFITT, MARGARET
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MOFFITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2264
Mailing Address - Country:US
Mailing Address - Phone:863-382-7983
Mailing Address - Fax:863-382-7983
Practice Address - Street 1:3901 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2264
Practice Address - Country:US
Practice Address - Phone:863-382-7983
Practice Address - Fax:863-382-7983
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X, 376J00000X, 3747P1801X, 376K00000X, 372600000X, 374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered374U00000XNursing Service Related ProvidersHome Health Aide
Not Answered376J00000XNursing Service Related ProvidersHomemaker
Not Answered3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Not Answered376K00000XNursing Service Related ProvidersNurse's Aide
Not Answered372600000XNursing Service Related ProvidersAdult Companion
Not Answered374700000XNursing Service Related ProvidersTechnician