Healthcare Provider Details

I. General information

NPI: 1255336863
Provider Name (Legal Business Name): LLOYD IAN MALINER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 NW 84TH AVE SUITE# 206
PLANTATION FL
33324-1807
US

IV. Provider business mailing address

PO BOX 565338
MIAMI FL
33256-5338
US

V. Phone/Fax

Practice location:
  • Phone: 954-862-7099
  • Fax: 954-577-1931
Mailing address:
  • Phone: 954-862-7099
  • Fax: 954-577-1931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME65773
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: