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Individual

JOHN E MALLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2664 SW IMMANUEL DR., PALM CITY, FL 34990-2738
(772) 288-3338
(772) 288-3341
Mailing address
2664 SW IMMANUEL DR., PALM CITY, FL 34990-2738
(772) 288-3338
(772) 288-3341

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO1806
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
87971
BCBS ID
FL
Enumeration date
06/13/2005
Last updated
11/09/2007
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