Malcolm R Bullock, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

0101058845 Issued in VA

Practice address

1475 NW 12TH Ave
Neurosurgery
Miami, FL 33136-1002

Phone

(305) 243-6946

Fax

(305) 243-3337

NPI assigned

Jul 4, 2006

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

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1457381220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 NW 14TH TER",
            "address_2": "2ND FLOOR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361060",
            "telephone_number": "305-243-6946",
            "fax_number": "305-243-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "address_2": "NEUROSURGERY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-6946",
            "fax_number": "305-243-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "MALCOLM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101058845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delzena Raquel Bulford-Frazier, M.S., R.D., L.D.N.,
• Shawn Doreen Buller, MT-BC
• Leisha F Bulli-Morgan, PA-C
• Devon Leigh Bullis, APRN
• Dominique Bullock
• Keissi Bulnes Arias
• Katya Bulnes Guevara
• Ana K Bulnes, LICSW
• Stephanie Nicole Bunch, APRN
• Brooke Buonocore

• Neurological Surgery Physician in Miami, FL
• Providers in Miami, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.