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General NPI Number Information
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NPI Number | 1356782445
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Entity Type | Individual
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Provider Name | MIREI MALAVE NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE BUILDING B -SUITE 1200
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-778-3184
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Fax | 706-238-8011
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Provider Business Mailing Address
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Address Line | 420 SE 8TH ST
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City | OCALA
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State | FL
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Zip | 34471-3760
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Country | US
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Telephone | 352-304-6480
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN11014767
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License Number State | FL
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