Healthcare Provider Details

I. General information

NPI: 1336222819
Provider Name (Legal Business Name): HIRAM MALARET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 AVE PONCE DE LEON SUITE 614 TORRE AUXILIO MUTUO
SAN JUAN PR
00917-5022
US

IV. Provider business mailing address

PO BOX 367148
SAN JUAN PR
00936-7148
US

V. Phone/Fax

Practice location:
  • Phone: 787-593-4436
  • Fax: 858-712-0653
Mailing address:
  • Phone: 787-593-4436
  • Fax: 858-712-0653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number6846
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: