Provider Demographics
NPI:1639227218
Name:TICONA, MARGARITA BETHZABE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:BETHZABE
Last Name:TICONA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4855 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE B2
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073
Mailing Address - Country:US
Mailing Address - Phone:954-418-1683
Mailing Address - Fax:954-418-1698
Practice Address - Street 1:2500 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009
Practice Address - Country:US
Practice Address - Phone:954-458-2572
Practice Address - Fax:954-354-8151
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9281094363A00000X
FL9281094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily