Individual
ANNA E MALINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1034 SE PROCTOR LN, PORT ST LUCIE, FL 34983-2616
(772) 595-5150
Mailing address
1034 SE PROCTOR LN, PORT ST LUCIE, FL 34983-2616
(724) 991-2111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA003849
PA
363A00000X
Physician Assistant
PA9115737
FL
363AM0700X
Medical Physician Assistant
Primary
MA057603
PA
Other
Enumeration date
06/08/2015
Last updated
01/29/2025
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