Provider Demographics
NPI:1275893588
Name:LUBBERS, MAEGAN (MD)
Entity type:Individual
Prefix:
First Name:MAEGAN
Middle Name:
Last Name:LUBBERS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 BOHART CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-6329
Mailing Address - Country:US
Mailing Address - Phone:407-840-8750
Mailing Address - Fax:
Practice Address - Street 1:101 AVENUE O SE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4333
Practice Address - Country:US
Practice Address - Phone:407-840-8750
Practice Address - Fax:407-649-4314
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126980207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119596300Medicaid