Provider Demographics
NPI:1922540632
Name:MALZONE, DANIEL JAY (RPH)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAY
Last Name:MALZONE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 SW 20TH ST
Mailing Address - Street 2:APT 202
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-8538
Mailing Address - Country:US
Mailing Address - Phone:973-747-8710
Mailing Address - Fax:
Practice Address - Street 1:1210 SW 33RD AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-2853
Practice Address - Country:US
Practice Address - Phone:800-622-4510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03642500183500000X
MAPH235784183500000X
NY060142183500000X
TN40739183500000X
VA0202215441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist