Provider Demographics
NPI:1124668371
Name:BIRAKIS, MEAGHAN MARGARET (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MEAGHAN
Middle Name:MARGARET
Last Name:BIRAKIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MEAGHAN
Other - Middle Name:MARGARET
Other - Last Name:DAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 S FEDERAL HWY APT 104
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-4905
Mailing Address - Country:US
Mailing Address - Phone:561-926-0401
Mailing Address - Fax:
Practice Address - Street 1:3319 FL-7 #202
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449
Practice Address - Country:US
Practice Address - Phone:561-847-4751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPAT9112567207NP0225X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology