Provider Demographics
NPI:1639216369
Name:MALY, STEVEN E (NP)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:MALY
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:3901 UNIVERSITY BLVD S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4312
Mailing Address - Country:US
Mailing Address - Phone:904-345-7373
Mailing Address - Fax:904-345-7372
Practice Address - Street 1:3901 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 103
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4312
Practice Address - Country:US
Practice Address - Phone:904-345-7373
Practice Address - Fax:904-345-7372
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2017-01-01
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Provider Licenses
StateLicense IDTaxonomies
FLARNP3301752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP84923Medicare UPIN