Brian J Mallette DPM LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO2692 Issued in FL

Legal business name

BRIAN J MALLETTE DPM LLC

Practice address

200 S Harbor City Blvd
Suite302
Melbourne, FL 32901-1384

Phone

(321) 728-0117

Fax

(321) 728-0151

NPI assigned

Mar 24, 2009

Last updated

Feb 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian J. Mallette, D.P.M.NPI 1669455291

Title

President

Phone

(321) 728-0117

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Joseph Mallette, D.P.M.

  • Podiatrist
  • Melbourne, FL
  • NPI 1669455291
  Medicare reassignment NPD Authorized official
• Claudia R. Mallette, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Melbourne, FL
  • NPI 1861633463
  NPD

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1073755963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S HARBOR CITY BLVD",
            "address_2": "SUITE302",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011384",
            "telephone_number": "321-728-0117",
            "fax_number": "321-728-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S HARBOR CITY BLVD",
            "address_2": "SUITE302",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011384",
            "telephone_number": "321-728-0117",
            "fax_number": "321-728-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN J MALLETTE DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "MALLETTE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-728-0117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brevard Wellness Center LLC (Space Coast Wellness Center)
• Brevard Wound Care Center, LLC
• Amanda Brezina
• Chad Breznay, PSYD
• Leigh A Breznay, PA-C, MPAS
• Colleen Patricia Briand, NP-C
• Briant G. Moyles D.P.M., P.a. (Melbourne Podiatry Associates)
• Matthew Edward Brice, D.O.
• Rajmohan Bridgelal, RPH
• Jacey Bridges

• Foot & Ankle Surgery Podiatrist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.