Provider Demographics
NPI:1851608244
Name:WIMBERLY, MARGARET P (ARNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:P
Last Name:WIMBERLY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:P
Other - Last Name:BARTHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1324 LAKELAND HILLS BLVD
Mailing Address - Street 2:ATTN: MANAGED CARE DEPT.
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3030 HARDEN BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-7952
Practice Address - Country:US
Practice Address - Phone:863-284-5000
Practice Address - Fax:863-284-5150
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9254891363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$OtherTRICARE
FL002689401Medicaid