Individual
DAVID JOEL MALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1499 S HARBOR CITY BLVD, SUITE 303, MELBOURNE, FL 32901-3245
(321) 254-5437
(321) 254-4543
Mailing address
1499 S HARBOR CITY BLVD, SUITE 303, MELBOURNE, FL 32901-3245
(321) 254-5437
(321) 254-4543
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
ME90348
FL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
ME90348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01269821
MEDICAID HMO - AMERIGROUP
FL
01
—
2067385
CIGNA
FL
01
—
2258392
MEDICAID HMO - UNITED HEALTH CARE
FL
05
—
271247400
—
FL
01
—
332181
MEDICAID HMO - WELLCARE
FL
01
—
48443
BCBS
FL
01
—
6774268
AETNA
FL
01
—
G98130
TRICARE SOUTH (HUMANA)
FL
Enumeration date
02/03/2006
Last updated
09/15/2011
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