Healthcare Provider Details

I. General information

NPI: 1659384576
Provider Name (Legal Business Name): MICHAEL A MALONE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 11/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 7TH ST S STE 205
ST PETERSBURG FL
33701-4708
US

IV. Provider business mailing address

601 7TH ST S STE 205
ST PETERSBURG FL
33701-4708
US

V. Phone/Fax

Practice location:
  • Phone: 727-893-6234
  • Fax: 727-553-7798
Mailing address:
  • Phone: 727-893-6234
  • Fax: 727-553-7798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberOS8313
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOS8313
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: