Individual
MR. SHANNON TRAVIS MALMQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8900 N. KENDALL DR, MIAMI CANCER INSTITUTE, MIAMI, FL 33176-2118
(786) 596-2000
(305) 279-7778
Mailing address
9350 SUNSET DR STE 200, MIAMI, FL 33173-3245
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9104405
FL
Other
Enumeration date
12/07/2007
Last updated
07/02/2021
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