Willie Nelson Malave, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9721 Issued in PR

Practice address

Carretera 129 KM 21.8
Int. 454 Bo. Callejones
Lares, PR 00669-0819

Phone

(787) 897-5555

Fax

(787) 897-2521

NPI assigned

May 4, 2006

Last updated

Oct 31, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Willie N Malave Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1447208244",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "CARR 129 KM 21.8",
            "city": "LARES",
            "state": "PUERTO RICO",
            "postal_code": "00669",
            "telephone_number": "787-897-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 129 KM 21.8",
            "address_2": "INT. 454 BO. CALLEJONES",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690819",
            "telephone_number": "787-897-5555",
            "fax_number": "787-897-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAVE",
        "first_name": "WILLIE",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "9721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIE",
            "last_name": "MALAVE",
            "middle_name": "N",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aida L Lopez
• Ileana Marys Lopez, PHARMD
• Carmen N Lugo, BS PH
• Vanessa Lugo, OT
• Lumen Mendez Pharmacy/Farmacia Lumen Mendez (Farmacia Lumen Mendez)
• Angel Luis Maldonado, M.A
• Belen Maldonado
• Desiree Maldonado
• Xiomara D. Martinez, APT
• Juan Matias, MD

• Pediatrics Physician in Lares, PR
• Providers in Lares, PR by specialty
• Pediatrics Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.