Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | PG169070 | OR |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | FM6765018 | FL |
NPI | 1225324387 |
---|---|
Provider Name | Dr. Jason Bradley Malone |
First Address | Jacksonville, FL 32256-0532 |
Second Address | Orlando, FL 32827-7402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2011 |
Last Update Date | 17/03/2018 |