Provider Demographics
NPI:1104898030
Name:WHITE, MARGO ELIZABETH (MOT/L)
Entity type:Individual
Prefix:MRS
First Name:MARGO
Middle Name:ELIZABETH
Last Name:WHITE
Suffix:
Gender:F
Credentials:MOT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-2139
Mailing Address - Country:US
Mailing Address - Phone:954-747-3790
Mailing Address - Fax:954-572-8032
Practice Address - Street 1:6720 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-2139
Practice Address - Country:US
Practice Address - Phone:954-747-3790
Practice Address - Fax:954-572-8032
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10482225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics