Provider Demographics
NPI:1548562440
Name:MALAVE, BETH ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:MALAVE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 SECRETARIAT RUN
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0336
Mailing Address - Country:US
Mailing Address - Phone:352-428-8524
Mailing Address - Fax:
Practice Address - Street 1:3037 LANDOVER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-7260
Practice Address - Country:US
Practice Address - Phone:352-340-5913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-28
Last Update Date:2010-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9205833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily