Ronsae Mallard, ARNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

9270748 Issued in FL

Practice address

10803 Carloway Hills Dr
Wimauma, FL 33598-6143

Phone

(386) 288-5697

NPI assigned

Jul 12, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inspiring Estates Inc

  • Adult Care Home Facility
  • Wimauma, FL
  • NPI 1871951103
  NPD (past) Authorized official

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404604800000",
    "number": "1326336249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10803 CARLOWAY HILLS DR",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335986143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10803 CARLOWAY HILLS DR",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335986143",
            "telephone_number": "386-288-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARD",
        "first_name": "RONSAE",
        "credential": "ARNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2014-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9270748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy First Healthcare Group, LLC
• Jeffrey Lester, MD
• Charnisha Lavern Lewis, MSW, RCSWI
• Jessica Lolies, CPT
• Yulieth A Londono
• Manatee Memorial Hospital LP
• Manatee Pathology Associates, PA
• Mariposa Wellness LLC
• Michael Massari, MD
• Dianna McCullough

• Adult Health Nurse Practitioner in Wimauma, FL
• Providers in Wimauma, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2014; 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.