Provider Demographics
NPI:1841397015
Name:MAS, MARGARITA G (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:G
Last Name:MAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:MARGARITA
Other - Middle Name:GAIL
Other - Last Name:LACRET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2343 NW 96TH WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-757-2507
Mailing Address - Fax:954-757-2507
Practice Address - Street 1:3435 N FEDERAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064
Practice Address - Country:US
Practice Address - Phone:954-781-0442
Practice Address - Fax:954-781-8595
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0012462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106S71800Medicaid
0SS6050690Medicare ID - Type Unspecified