Provider Demographics
NPI:1770043366
Name:LUMMUS, MARGARET (HAS)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:LUMMUS
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:MARGIE
Other - Middle Name:
Other - Last Name:LUMMUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HAS
Mailing Address - Street 1:122 EGLIN PKWY NE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-4917
Mailing Address - Country:US
Mailing Address - Phone:850-243-3196
Mailing Address - Fax:850-270-5124
Practice Address - Street 1:122 EGLIN PKWY NE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-4917
Practice Address - Country:US
Practice Address - Phone:850-243-3196
Practice Address - Fax:850-270-5124
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5420237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11111OtherNA