Individual
MS. CONSTANCE W. MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RD, LDN, CDE
Contact information
Practice address
JAMES A. HALEY VA HOSPITAL (120), 13000 BRUCE B. DOWNS BLVD., TAMPA, FL 33612-4745
(813) 972-2000
Mailing address
1024 FOXWOOD DR, LUTZ, FL 33549-4137
(813) 949-8459
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND000668
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10742
REGISTERED DIETITIAN
—
Enumeration date
06/27/2006
Last updated
07/08/2007
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