MEDICARE: MALCOLM C MACLAREN DO

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	207X00000X	Orthopaedic Surgery Physician	OS8857	FL
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	OS8857	FL
3	207XX0801X	Orthopaedic Trauma Physician	OS8857	FL
4	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	OS8857	FL
5	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	OS8857	FL
6	207XS0106X	Orthopaedic Hand Surgery Physician	OS8857	FL
7	207XP3100X	Pediatric Orthopaedic Surgery Physician	OS8857	FL

General Provider Information

NPI Number	:	1801891270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALCOLM C MACLAREN DO

Provider Business Mailing Address
First Line	:	18133 PATTERSON RD
Second Line	:
City	:	ODESSA
State	:	FL
Zip	:	33556-2214
Country	:	US
Telephone Number	:	813-496-1075
Fax Number	:	813-249-7762

Provider Business Practice Location Address
First Line	:	18133 PATTERSON RD
Second Line	:
City	:	ODESSA
State	:	FL
Zip	:	33556-2214
Country	:	US
Telephone Number	:	813-496-1075
Fax Number	:	813-249-7762

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	02/04/2009

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