Mallis, Marc Jeffrey

Mallis, Marc Jeffrey is an individual health care provider with primary practice located at 5347 Main St Ste 102, New Port Richey FL 34652-2506. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mallis, Marc Jeffrey can be contacted via phone (727) 845-1343.

Contact Information

Primary practice address
5347 Main St Ste 102 New Port Richey FL 34652-2506
Phone: (727) 845-1343
Fax: (727) 845-1343
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME 0037030 Florida

Profile Details

NPI number 1811992050
LBN Legal business name Mallis, Marc Jeffrey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Feb 24th, 2009 - about 15 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 1811992050 NPPES
Florida MEDICAID 054865101

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