Mallis, Marc Jeffrey
Mallis, Marc Jeffrey is an individual health care provider with primary practice located at 5347 Main St Ste 102, New Port Richey FL 34652-2506. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mallis, Marc Jeffrey can be contacted via phone (727) 845-1343.Contact Information
Primary practice address
5347 Main St Ste 102
New Port Richey FL 34652-2506
Phone: (727) 845-1343
Fax: (727) 845-1343
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | ME 0037030 | Florida |
Profile Details
| NPI number | 1811992050 |
|---|---|
| LBN Legal business name | Mallis, Marc Jeffrey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2005 |
| Last updated | Feb 24th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811992050 | NPPES |
| Florida | MEDICAID | 054865101 |
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