Provider Demographics
NPI:1710950373
Name:MIKELONIS, MARGARET (PEGGY) ANN (ARNP-C)
Entity Type:Individual
Prefix:MS
First Name:MARGARET (PEGGY)
Middle Name:ANN
Last Name:MIKELONIS
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:MS
Other - First Name:MARGARET (PEGGY)
Other - Middle Name:ANN
Other - Last Name:MCCANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-C
Mailing Address - Street 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:WOMEN'S CENTER (11WV)
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-972-2000
Mailing Address - Fax:813-979-3615
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:WOMEN'S CENTER (11WV)
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:813-979-3615
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL908492363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health