Provider Demographics
NPI:1912454141
Name:CARLTON, MARGARET ALICE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ALICE
Last Name:CARLTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:TARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1950 ARLINGTON ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3513
Mailing Address - Country:US
Mailing Address - Phone:941-917-4250
Mailing Address - Fax:941-917-4257
Practice Address - Street 1:1950 ARLINGTON ST STE 400
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3513
Practice Address - Country:US
Practice Address - Phone:941-917-4250
Practice Address - Fax:941-917-4257
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109844363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100270600Medicaid