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General NPI Number Information
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NPI Number | 1043126410
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Entity Type | Individual
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Provider Name | MALISHA MAGLY ACNPC-AG
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Gender | Female
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 1 SHIRCLIFF WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4748
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Country | US
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Telephone | 512-730-3060
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 INDIGO AVE
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City | MIDDLEBURG
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State | FL
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Zip | 32068-6004
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Country | US
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Telephone | 912-400-1860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11049776
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License Number State | FL
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