David Joel Malis
Pediatric Otolaryngology Otolaryngology/Facial Plastic Surgery
1499 S Harbor City Blvd Suite 303
Melbourne
, Florida 32901-3245
David Joel Malis
Pediatric Otolaryngology Otolaryngology/Facial Plastic Surgery
1499 S Harbor City Blvd Suite 303
Melbourne
, Florida 32901-3245
(321) 254-4543
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About
Features
Specialties
- Pediatric Otolaryngology
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- David Joel Malis
- 1499 S Harbor City Blvd Suite 303
- Melbourne, FL
- Zip : 32901-3245
- Fax : (321) 254-4543
- Phone : (321) 254-5437
Second Address
- David Joel Malis
- 1499 S Harbor City Blvd Suite 303
- Melbourne, FL
- Zip : 32901-3245
- Fax : (321) 254-4543
- Phone : (321) 254-5437
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YP0228X | Pediatric Otolaryngology | ME90348 | FL |
| N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME90348 | FL |
National Provider Identifier
| NPI | 1649242538 |
|---|---|
| Provider Name | David Joel Malis |
| First Address | Melbourne, FL 32901-3245 |
| Second Address | Melbourne, FL 32901-3245 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/02/2006 |
| Last Update Date | 15/09/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01269821 | MEDICAID HMO - AMERIGROUP (01) | FL |
| 2067385 | CIGNA (01) | FL |
| 2258392 | MEDICAID HMO - UNITED HEALTH CARE (01) | FL |
| 271247400 | (05) | FL |
| 332181 | MEDICAID HMO - WELLCARE (01) | FL |
| 48443 | BCBS (01) | FL |
| 6774268 | AETNA (01) | FL |
| G98130 | TRICARE SOUTH (HUMANA) (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.