Provider Demographics
NPI:1225324387
Name:MALONE, JASON BRADLEY (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:BRADLEY
Last Name:MALONE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:10140 CENTURION PKWY N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0532
Mailing Address - Country:US
Mailing Address - Phone:904-697-4127
Mailing Address - Fax:904-697-5102
Practice Address - Street 1:13535 NEMOURS PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7402
Practice Address - Country:US
Practice Address - Phone:407-567-4000
Practice Address - Fax:407-567-5924
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
ORPG169070207X00000X
FLFM6765018207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery