Basic Information
| Provider Information | |||||||||
| NPI: | 1013160399 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MATHEWS-D'AVANZO | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4675 LINTON BOULVEARD | ||||||||
| Address2: | 202 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614955700 | ||||||||
| FaxNumber: | 5614952020 | ||||||||
| Practice Location | |||||||||
| Address1: | 4675 LINTON BOULVEARD | ||||||||
| Address2: | 202 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614955700 | ||||||||
| FaxNumber: | 5614952020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2008 | ||||||||
| LastUpdateDate: | 10/30/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2157962 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.