Provider Demographics
NPI:1992103469
Name:PAUL, MAGDALA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MAGDALA
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:MAGDALA
Other - Middle Name:
Other - Last Name:JEAN JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:511 RADFORD TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-6426
Mailing Address - Country:US
Mailing Address - Phone:768-274-2441
Mailing Address - Fax:
Practice Address - Street 1:100 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-4520
Practice Address - Country:US
Practice Address - Phone:786-274-2441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9283444261QP2300X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse