Provider Demographics
NPI:1942243241
Name:DIGAETANO, MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:DIGAETANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 HEALTH BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-1493
Mailing Address - Country:US
Mailing Address - Phone:386-255-5050
Mailing Address - Fax:386-255-5029
Practice Address - Street 1:505 HEALTH BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1493
Practice Address - Country:US
Practice Address - Phone:386-255-5050
Practice Address - Fax:386-255-5029
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055254207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061999000Medicaid
FL08839ZMedicare ID - Type Unspecified
FL061999000Medicaid