Provider Demographics
NPI:1225469190
Name:MALIK, JAWAD ABDUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAWAD
Middle Name:ABDUL
Last Name:MALIK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 GOVERNORS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-7640
Mailing Address - Country:US
Mailing Address - Phone:407-913-3965
Mailing Address - Fax:407-290-8464
Practice Address - Street 1:710 GOVERNORS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7640
Practice Address - Country:US
Practice Address - Phone:407-913-3965
Practice Address - Fax:407-290-8464
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3628213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist