Individual
MRS. SAMANTHA MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4645 NW 8TH AVE, GAINESVILLE, FL 32605-4524
(352) 375-1212
Mailing address
4645 NW 8TH AVE, GAINESVILLE, FL 32605-4524
(352) 375-1212
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9179257
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP9179257
MEDICAL LICENSE #
FL
Enumeration date
09/14/2006
Last updated
07/08/2007
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