Organization Active NPI

Jawad a. Malik, D.P.M., P.a.

  • Foot & Ankle Surgery Podiatrist
  • Orlando, FL
National Provider Identifier
1043600968
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO 3628 Issued in FL
Legal business name
JAWAD A. MALIK, D.P.M., P.A.
Practice address
710 Governors Ave
Orlando, FL 32808-7640
Phone
(407) 913-3965
NPI assigned
Jan 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jawad Abdul Malik, DPMNPI 1225469190
Title
Presdient
Phone
(407) 913-3965

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO 3628 FL Primary

Addresses

Primary practice location

710 Governors Ave
Orlando, FL 32808-7640

Mailing address

710 Governors Ave
Orlando, FL 32808-7640
Phone (407) 913-3965

Other practice location 1

7758 Wallace Rd Ste 6
Orlando, FL 32819-7217
Phone (407) 913-3965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150317000536 FL Part B Supplier - Clinic/Group Practice 7113244989 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

7758 Wallace Rd
Orlando, FL 32819
Phone (800) 748-2129

7758 Wallace Rd
Ste 7
Orlando, FL 32819

710 Governors Ave
Orlando, FL 32808
Phone (407) 299-9717

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1043600968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 GOVERNORS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087640",
            "telephone_number": "407-913-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 GOVERNORS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087640",
            "telephone_number": "407-913-3965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7758 Wallace Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328197217",
            "country_code": "US",
            "telephone_number": "407-913-3965",
            "fax_number": "407-290-8464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAWAD A. MALIK, D.P.M., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "JAWAD",
        "authorized_official_middle_name": "ABDUL",
        "authorized_official_title_or_position": "PRESDIENT",
        "authorized_official_telephone_number": "407-913-3965",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.