Individual provider Active NPI

Jawed Akhter Mallick, MBBS

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1376191023
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TRN44695 Issued in FL
Practice address
201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
Phone
(386) 425-4165
Fax
(386) 425-7545
NPI assigned
Aug 27, 2019
Last updated
Jul 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN44695 FL Primary

Addresses

Primary practice location

201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765

Mailing address

201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
Phone (386) 425-4165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191028001877 FL Practitioner - Nurse Practitioner 4284966045 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709
Phone (386) 254-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Oct 3, 2019 Accepting new patients
Emergency Physicians of Central Florida LLP CurrentSince Oct 1, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 3, 2019 Accepting new patients
Halifax Healthcare Systems Inc Family Medicine CurrentSince Mar 1, 2022 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

201 N Clyde Morris Blvd
Ste 200
Daytona Beach, FL 32114
Phone (386) 254-4165

3300 E Halifax Crossing Blvd
Deltona, FL 32725
Phone (386) 425-1800

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

10000 W Colonial Dr
Ocoee, FL 34761
Phone (321) 843-1378

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1376191023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142765",
            "telephone_number": "386-425-4165",
            "fax_number": "386-425-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142765",
            "telephone_number": "386-425-4165",
            "fax_number": "386-425-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "JAWED",
        "middle_name": "AKHTER",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN44695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.