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Individual

DR. RICHARD SANTO MALLIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
16812 NW 73RD CT, HIALEAH, FL 33015-4114
(305) 632-9975
(305) 823-3085
Mailing address
16812 NW 73RD CT, HIALEAH, FL 33015-4114
(305) 632-9975
(305) 823-3085

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO2953
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
340242800
FL
Enumeration date
07/15/2006
Last updated
09/11/2012
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