Jamie A Mallah, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME98703 Issued in FL

Practice address

4683 Van Dyke Rd
Lutz, FL 33558-4880

Phone

(813) 968-7171

Fax

(813) 968-7282

NPI assigned

Aug 5, 2007

Last updated

Sep 21, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1245421403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 EISENHOWER BLVD",
            "address_2": "SUITE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346344",
            "telephone_number": "813-636-2000",
            "fax_number": "813-286-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4683 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584880",
            "telephone_number": "813-968-7171",
            "fax_number": "813-968-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAH",
        "first_name": "JAMIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME98703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279016500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faddy A Makaryus, DMD
• Kevin J. Makati, MD
• Viba Bhuvana Malaiyandi, MD
• Jessica Malave, MSN, APRN, FNP-BC
• Padmavathi Malempati, M.D.
• Kimberly Ann Mandato
• Wagih F Mankarious, RPH
• Jeanine Manovill
• Yizenia Marcano
• Marcella P Jones DO Family Medicine and Weight Loss PLLC

• Pediatrics Physician in Lutz, FL
• Providers in Lutz, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.