Healthcare Provider Details

I. General information

NPI: 1598795536
Provider Name (Legal Business Name): ERIC MALZ PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date: 04/13/2026
Reactivation Date: 05/26/2026

III. Provider practice location address

1201 US HIGHWAY 1 STE 250
NORTH PALM BEACH FL
33408-3598
US

IV. Provider business mailing address

1201 US HIGHWAY 1 STE 250
NORTH PALM BEACH FL
33408-3598
US

V. Phone/Fax

Practice location:
  • Phone: 561-747-2775
  • Fax: 561-747-1881
Mailing address:
  • Phone: 561-747-2775
  • Fax: 561-747-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number400555
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NC11014300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11024056
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: