# BRIAN J MALLETTE DPM LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073755963
- **Authorized official:** DR. BRIAN J. MALLETTE D.P.M. (PRESIDENT)
- **Authorized official phone:** (321) 728-0117

## Contact information

- **Practice address:** 200 S HARBOR CITY BLVD, SUITE302, MELBOURNE, FL 32901-1384
- **Practice address phone:** (321) 728-0117
- **Practice address fax:** (321) 728-0151
- **Mailing address:** 200 S HARBOR CITY BLVD, SUITE302, MELBOURNE, FL 32901-1384
- **Mailing address phone:** (321) 728-0117
- **Mailing address fax:** (321) 728-0151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO2692 | FL | Yes |

## Other

- **Enumeration date:** 03/24/2009
- **Last updated:** 02/18/2015