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General NPI Number Information
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NPI Number | 1851615124
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Entity Type | Individual
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Provider Name | MARSHA MALLETT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/16/2010
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 9783 SW 72ND ST
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City | MIAMI
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State | FL
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Zip | 33173-4615
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Country | US
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Telephone | 786-879-3499
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Fax | 305-275-9148
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Provider Business Mailing Address
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Address Line | 70 SW 91ST AVE #208
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City | PLANTATION
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State | FL
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Zip | 33324-2576
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Country | US
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Telephone | 786-879-3499
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Fax | 305-275-9148
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PS41157
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License Number State | FL
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