Provider Demographics
NPI:1740527803
Name:MALBAURN, MARGARET
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:
Last Name:MALBAURN
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 1:4101 HOOD RD
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2171
Mailing Address - Country:US
Mailing Address - Phone:561-624-0559
Mailing Address - Fax:
Practice Address - Street 1:4101 HOOD RD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2171
Practice Address - Country:US
Practice Address - Phone:561-624-0559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist