Provider Demographics
NPI:1013160399
Name:MATHEWS-D'AVANZO, MARGARET ANN
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:MATHEWS-D'AVANZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 LINTON BOULVEARD
Mailing Address - Street 2:202
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445
Mailing Address - Country:US
Mailing Address - Phone:561-495-5700
Mailing Address - Fax:561-495-2020
Practice Address - Street 1:4675 LINTON BOULVEARD
Practice Address - Street 2:202
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445
Practice Address - Country:US
Practice Address - Phone:561-495-5700
Practice Address - Fax:561-495-2020
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2157962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily