Individual
ERIN E MALLARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8791 CONFERENCE DR STE 100, FORT MYERS, FL 33919-5822
(239) 331-5566
(239) 437-7499
Mailing address
8791 CONFERENCE DR STE 100, FORT MYERS, FL 33919-5822
(239) 331-5566
(239) 437-7499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103462
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292574500
—
FL
01
—
LG171
MEDICARE
FL
01
—
Y01T5
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/05/2006
Last updated
06/26/2024
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