Provider Demographics
NPI:1073297784
Name:BRATHWAITE, MALAIKA
Entity Type:Individual
Prefix:
First Name:MALAIKA
Middle Name:
Last Name:BRATHWAITE
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 1:1707 ORLANDO CENTRAL PKWY STE 480
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-5785
Mailing Address - Country:US
Mailing Address - Phone:407-382-9079
Mailing Address - Fax:407-964-1274
Practice Address - Street 1:1707 ORLANDO CENTRAL PKWY STE 480
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5785
Practice Address - Country:US
Practice Address - Phone:407-382-9079
Practice Address - Fax:407-964-1274
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical