Healthcare Provider Details

I. General information

NPI: 1013160399
Provider Name (Legal Business Name): MRS. MARGARET ANN MATHEWS-D'AVANZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4675 LINTON BOULVEARD 202
DELRAY BEACH FL
33445
US

IV. Provider business mailing address

4675 LINTON BOULVEARD 202
DELRAY BEACH FL
33445
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-5700
  • Fax: 561-495-2020
Mailing address:
  • Phone: 561-495-5700
  • Fax: 561-495-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2157962
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: