Individual
MARGARETTE REVOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9914 SHEPARD PL, WELLINGTON, FL 33414-6467
(561) 670-6977
Mailing address
9914 SHEPARD PL, WELLINGTON, FL 33414-6467
(561) 670-6977
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L18000193723
—
FL
Enumeration date
08/23/2019
Last updated
08/23/2019
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