Healthcare Provider Details

I. General information

NPI: 1396399580
Provider Name (Legal Business Name): MALEK AL BARBANDI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136
US

IV. Provider business mailing address

1611 NW 12TH AVE
MIAMI FL
33136
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-5437
  • Fax:
Mailing address:
  • Phone: 305-585-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME165002
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberME165002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: