Provider Demographics
NPI:1013132570
Name:ROSA MALNATI DPM INC
Entity Type:Organization
Organization Name:ROSA MALNATI DPM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALNATI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:352-351-5502
Mailing Address - Street 1:550A MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-8558
Mailing Address - Country:US
Mailing Address - Phone:352-351-5502
Mailing Address - Fax:352-369-5503
Practice Address - Street 1:150 SE 17TH ST
Practice Address - Street 2:UNIT # 502
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5178
Practice Address - Country:US
Practice Address - Phone:352-351-5502
Practice Address - Fax:352-369-5503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2746213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340600800Medicaid
FLDG1460OtherRAILROAD MEDICARE GROUP #
FLP00418771OtherRAILROAD MEDICARE PTAN
FLP00418771OtherRAILROAD MEDICARE PTAN
FL65609WMedicare ID - Type UnspecifiedINDIVIDUAL NUMBER
FLAC007Medicare ID - Type UnspecifiedGROUP NUMBER
FLDG1460OtherRAILROAD MEDICARE GROUP #