Healthcare Provider Details

I. General information

NPI: 1467381509
Provider Name (Legal Business Name): MINA ABDELMALEK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 US HIGHWAY 27 S
SEBRING FL
33870-4920
US

IV. Provider business mailing address

26906 HAVERHILL DR
LUTZ FL
33559-8513
US

V. Phone/Fax

Practice location:
  • Phone: 863-247-2951
  • Fax:
Mailing address:
  • Phone: 727-301-9228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: