Provider Demographics
NPI:1265546154
Name:SINGH, MALA (DO)
Entity type:Individual
Prefix:DR
First Name:MALA
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MALA
Other - Middle Name:NATH
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6918 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3800
Mailing Address - Country:US
Mailing Address - Phone:813-891-6310
Mailing Address - Fax:813-891-6889
Practice Address - Street 1:6918 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625
Practice Address - Country:US
Practice Address - Phone:813-891-6310
Practice Address - Fax:813-891-6889
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9476207Q00000X
FLOS11730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI49582Medicare UPIN