1275718843 NPI number — MS. MARGARET LILLIAN LALOR ARNP

Table of content: MS. MARGARET LILLIAN LALOR ARNP (NPI 1275718843)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275718843 NPI number — MS. MARGARET LILLIAN LALOR ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LALOR
Provider First Name:
MARGARET
Provider Middle Name:
LILLIAN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LALOR
Provider Other First Name:
PEGGI
Provider Other Middle Name:
LILLIAN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1275718843
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 66TH ST. N.
Provider Second Line Business Mailing Address:
SUITE 510
Provider Business Mailing Address City Name:
ST. PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33710-5512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-384-2479
Provider Business Mailing Address Fax Number:
727-384-3573

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 66TH ST. N.
Provider Second Line Business Practice Location Address:
SUITE 510
Provider Business Practice Location Address City Name:
ST. PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33710-5512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-384-2479
Provider Business Practice Location Address Fax Number:
727-384-3573
Provider Enumeration Date:
01/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  ARNP2711732 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008755800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 101219100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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