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General NPI Number Information
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NPI Number | 1184749871
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Entity Type | Organization
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Legal Business Name | MARGARET G. MAYO, M.D. PA
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 22091 ELMIRA BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-7018
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Country | US
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Telephone | 941-624-4748
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Fax |
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Provider Business Mailing Address
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Address Line | 22091 ELMIRA BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-7018
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Country | US
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Telephone | 941-624-4748
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARGARET G MAYO
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Credential | MD
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Telephone | 941-624-4748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME57311
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License Number State | FL
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