Healthcare Provider Details

I. General information

NPI: 1134052384
Provider Name (Legal Business Name): ROXANA CHAVIANO MALBOA PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 SW 90TH ST # E707
MIAMI FL
33156-8326
US

IV. Provider business mailing address

7280 SW 90TH ST # E707
MIAMI FL
33156-8326
US

V. Phone/Fax

Practice location:
  • Phone: 786-597-7756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberPS64917
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: