Provider Demographics
NPI:1376583682
Name:MALONE, GEORGE DARREN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:DARREN
Last Name:MALONE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12532 HERONS PATH PL
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-3393
Mailing Address - Country:US
Mailing Address - Phone:813-567-1479
Mailing Address - Fax:
Practice Address - Street 1:919 53RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4801
Practice Address - Country:US
Practice Address - Phone:941-751-8132
Practice Address - Fax:941-751-8113
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS378091835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy