Provider Demographics
NPI:1245708817
Name:DANDREANO, MARGO (LM, CPM)
Entity type:Individual
Prefix:
First Name:MARGO
Middle Name:
Last Name:DANDREANO
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16810 S US HIGHWAY 441 STE 506
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8680
Mailing Address - Country:US
Mailing Address - Phone:352-361-2095
Mailing Address - Fax:
Practice Address - Street 1:16810 S US HIGHWAY 441 STE 506
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8680
Practice Address - Country:US
Practice Address - Phone:352-361-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW372176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty