MEDICARE: DEJON MALONEY M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	ME138399	FL
2	207Q00000X	Family Medicine Physician	ME138399	FL
3	207Q00000X	Family Medicine Physician	1518499235	FL
4	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518499235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEJON MALONEY M.D

Provider Business Mailing Address
First Line	:	700 6TH ST S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4815
Country	:	US
Telephone Number	:	727-893-6116
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 6TH ST S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4815
Country	:	US
Telephone Number	:	727-893-6116
Fax Number	:	727-553-7340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2017
Last Update Date	:	01/08/2026

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Directions to “ DEJON MALONEY M.D” Practice Location

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