Provider Demographics
NPI:1891780318
Name:PEARSON MALUSO MD PA
Entity Type:Organization
Organization Name:PEARSON MALUSO MD PA
Other - Org Name:REGIONAL ORTHOPAEDIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-843-2130
Mailing Address - Street 1:77 W UNDERWOOD ST
Mailing Address - Street 2:5TH FL
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806
Mailing Address - Country:US
Mailing Address - Phone:407-843-2130
Mailing Address - Fax:407-425-3984
Practice Address - Street 1:77 WEST UNDERWOOD ST
Practice Address - Street 2:5TH FL
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:407-843-2130
Practice Address - Fax:407-425-3984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99525Medicare ID - Type Unspecified