Provider Demographics
NPI:1851615124
Name:MALLETT, MARSHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:
Last Name:MALLETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SW 91ST AVE
Mailing Address - Street 2:#208
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2576
Mailing Address - Country:US
Mailing Address - Phone:786-879-3499
Mailing Address - Fax:305-275-9148
Practice Address - Street 1:9783 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4615
Practice Address - Country:US
Practice Address - Phone:786-879-3499
Practice Address - Fax:305-275-9148
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS411571835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy