Mallah, Jamie A

Mallah, Jamie A is an individual health care provider with primary practice located at 4683 Van Dyke Rd , Lutz FL 33558-4880. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mallah, Jamie A can be contacted via phone (813) 968-7171.

Contact Information

Primary practice address
4683 Van Dyke Rd Lutz FL 33558-4880
Phone: (813) 968-7171
Fax: (813) 968-7282
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME98703 Florida

Profile Details

NPI number 1245421403
LBN Legal business name Mallah, Jamie A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Sep 21st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245421403 NPPES
Florida MEDICAID 279016500

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