Individual
MOKENGE MALAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12902 USF MAGNOLIA DR, MDC 44, TAMPA, FL 33612-9416
(813) 745-1432
(813) 745-3829
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME91541
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265792900
—
FL
01
—
62862
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/19/2006
Last updated
12/13/2007
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