Provider Demographics
NPI:1225452576
Name:MALVEHY MEDICAL, P.A.
Entity Type:Organization
Organization Name:MALVEHY MEDICAL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALVEHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-763-8734
Mailing Address - Street 1:400 W 41ST ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3516
Mailing Address - Country:US
Mailing Address - Phone:305-763-8734
Mailing Address - Fax:305-424-9226
Practice Address - Street 1:400 W 41ST ST
Practice Address - Street 2:SUITE 311
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3516
Practice Address - Country:US
Practice Address - Phone:305-763-8734
Practice Address - Fax:305-424-9226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114670207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89134R7Medicaid