Individual
IRENE ELAINE MALESIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12412 SAN JOSE BLVD, SUITE 104, JACKSONVILLE, FL 32223-8620
(904) 292-4755
(904) 292-9243
Mailing address
12412 SAN JOSE BLVD, SUITE 104, JACKSONVILLE, FL 32223-8620
(904) 292-4755
(904) 292-9243
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36753
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15570
BCBS
FL
Enumeration date
09/15/2006
Last updated
07/08/2007
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