MEDICARE: CAROL MALOCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	10072	FL

General Provider Information

NPI Number	:	1225114697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL MALOCH

Provider Business Mailing Address
First Line	:	1202 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5364
Country	:	US
Telephone Number	:	772-335-3088
Fax Number	:	772-398-0041

Provider Business Practice Location Address
First Line	:	1202 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5364
Country	:	US
Telephone Number	:	772-335-3088
Fax Number	:	772-398-0041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1760568133 — SUSAN M CAWLEY
Practice Location Address:

1202 SE PORT ST LUCIE BLVD
PORT ST LUCIE, FL
34952-5364

Practice Phone: 772-335-3088
Practice Fax: 772-398-0041

1003992488 — W & B DENTISTRY PA
Practice Location Address:

1202 SE PORT ST LUCIE BLVD , SB
PORT ST LUCIE, FL
34952-5364

Practice Phone: 772-335-3088
Practice Fax: 772-398-0041

1194083634 — MRS. YVETTE E MCDONALD LCSW
Practice Location Address:

1222 SE PORT ST LUCIE BLVD
PORT SAINT LUCIE, FL
34952-5364

Practice Phone: 772-361-8448
Practice Fax: 844-269-6480

1578818126 — STEVEN KLINE DDS
Practice Location Address:

1202 SE PORT ST LUCIE BLVD
PORT SAINT LUCIE, FL
34952-5364

Practice Phone: 772-335-3088
Practice Fax: 772-398-0041

1639582372 — DR. ADAM WALTERS DMD
Practice Location Address:

1202 SE PORT ST LUCIE BLVD
PORT SAINT LUCIE, FL
34952-5364

Practice Phone: 772-335-3088
Practice Fax:

1396100657 — TRAVELING LIGHT COUNSELING INC
Practice Location Address:

1222 SE PORT ST LUCIE BLVD
PORT SAINT LUCIE, FL
34952-5364

Practice Phone: 772-361-8448
Practice Fax: 844-269-6480

Directions to “ CAROL MALOCH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.