Healthcare Provider Details

I. General information

NPI: 1134239007
Provider Name (Legal Business Name): JULIA T MALAVET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CALLE 2 GARDEN HILLS ESTATES
GUAYNABO PR
00966-2907
US

IV. Provider business mailing address

26 CALLE 2 GARDEN HILLS ESTATES
GUAYNABO PR
00966-2907
US

V. Phone/Fax

Practice location:
  • Phone: 787-249-2241
  • Fax:
Mailing address:
  • Phone: 787-249-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number10199
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: