Provider Demographics
NPI:1215134168
Name:DAMAS, MARGARETTE
Entity type:Individual
Prefix:
First Name:MARGARETTE
Middle Name:
Last Name:DAMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25926
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33320
Mailing Address - Country:US
Mailing Address - Phone:954-726-7441
Mailing Address - Fax:954-726-7731
Practice Address - Street 1:3100 CORAL HILLS DR
Practice Address - Street 2:SUITE 308
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4137
Practice Address - Country:US
Practice Address - Phone:954-796-9060
Practice Address - Fax:954-796-9061
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME878972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269297000Medicaid
FL269297000Medicaid
H05532Medicare UPIN