Provider Demographics
NPI:1700077021
Name:MALAVE-HUERTAS, DENI (MD)
Entity Type:Individual
Prefix:
First Name:DENI
Middle Name:
Last Name:MALAVE-HUERTAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 GREY FALCON CIR SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-8616
Mailing Address - Country:US
Mailing Address - Phone:787-667-3805
Mailing Address - Fax:
Practice Address - Street 1:1050 37TH PL
Practice Address - Street 2:SUITE 101 & 102
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6578
Practice Address - Country:US
Practice Address - Phone:772-770-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26185207V00000X
FLME 102221207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology