Provider Demographics
NPI:1619423522
Name:MALPICA, INDIRA (BS, DC)
Entity Type:Individual
Prefix:DR
First Name:INDIRA
Middle Name:
Last Name:MALPICA
Suffix:
Gender:F
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11360 LEGACY AVE UNIT 110
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3663
Mailing Address - Country:US
Mailing Address - Phone:561-566-0447
Mailing Address - Fax:
Practice Address - Street 1:11360 LEGACY AVE UNIT 110
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3663
Practice Address - Country:US
Practice Address - Phone:561-566-0447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0615111N00000X
FL12067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor