Healthcare Provider Details

I. General information

NPI: 1932887635
Provider Name (Legal Business Name): ERIKA MALANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 S COMPASS WAY
DANIA BEACH FL
33004-2368
US

IV. Provider business mailing address

4500 PARSONS BLVD
FLUSHING NY
11355-2205
US

V. Phone/Fax

Practice location:
  • Phone: 954-807-9433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberOS21322
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: