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General NPI Number Information
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NPI Number | 1043600968
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Entity Type | Organization
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Legal Business Name | JAWAD A. MALIK, D.P.M., P.A.
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 710 GOVERNORS AVE
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City | ORLANDO
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State | FL
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Zip | 32808-7640
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Country | US
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Telephone | 407-913-3965
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Fax |
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Provider Business Mailing Address
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Address Line | 710 GOVERNORS AVE
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City | ORLANDO
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State | FL
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Zip | 32808-7640
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Country | US
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Telephone | 407-913-3965
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Fax |
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Authorized Official
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Title or Position | PRESDIENT
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Name | JAWAD ABDUL MALIK
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Credential | DPM
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Telephone | 407-913-3965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO 3628
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License Number State | FL
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