Individual
JAMIE A MALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4683 VAN DYKE RD, LUTZ, FL 33558-4880
(813) 968-7171
(813) 968-7282
Mailing address
4902 EISENHOWER BLVD, SUITE 300, TAMPA, FL 33634-6344
(813) 636-2000
(813) 286-8835
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME98703
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279016500
—
FL
Enumeration date
08/05/2007
Last updated
09/21/2011
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