Healthcare Provider Details

I. General information

NPI: 1528877065
Provider Name (Legal Business Name): MARGAUX MALONEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12920 US HIGHWAY 1 STE A
SEBASTIAN FL
32958-3772
US

IV. Provider business mailing address

12920 US HIGHWAY 1 STE A
SEBASTIAN FL
32958-3772
US

V. Phone/Fax

Practice location:
  • Phone: 772-388-8322
  • Fax: 772-388-8323
Mailing address:
  • Phone: 772-388-8322
  • Fax: 772-388-8323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11034195
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: