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General NPI Number Information
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NPI Number | 1225336266
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Entity Type | Organization
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Legal Business Name | MALY'S SPECIAL SUPPORT INC
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 2646 NW 21 TERR
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City | MIAMI
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State | FL
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Zip | 33142
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Country | US
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Telephone | 786-523-4197
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Fax | 305-635-2328
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Provider Business Mailing Address
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Address Line | PO BOX 420793
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City | MIAMI
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State | FL
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Zip | 33242
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Country | US
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Telephone | 786-338-3304
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Fax | 786-717-6420
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Authorized Official
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Title or Position | OWNER
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Name | MALIKA BERROA
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Credential |
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Telephone | 786-338-3304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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