Provider Demographics
NPI:1295057057
Name:MALAVE, SYLVIA
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:MALAVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 AVE LOS DOMINICOS # URB
Mailing Address - Street 2:CALLE 10 BLOQUE 22 CASA 7
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-6707
Mailing Address - Country:US
Mailing Address - Phone:787-797-5118
Mailing Address - Fax:
Practice Address - Street 1:CALLE 10 BLOQUE 22 CASA 7
Practice Address - Street 2:URB MIRAFLORES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-6707
Practice Address - Country:US
Practice Address - Phone:787-797-5118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00501225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist