Individual
MALIENA MICHI LONGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14105 MCCORMICK DR, TAMPA, FL 33626-3019
(813) 873-1177
Mailing address
5804 CRUISER WAY, TAMPA, FL 33615-4215
(813) 494-4545
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
73221
CT
207K00000X
Allergy & Immunology Physician
Primary
ME102587
FL
Other
Enumeration date
10/15/2007
Last updated
06/12/2023
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