Active NPI
James Elias Mallabo
- Physical Therapist
- Orlando, FL
National Provider Identifier
1497511703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 23168
- Practice address
- 13800 Veterans Way
Orlando, FL 32827-7401 - Phone
- (407) 631-1000
- NPI assigned
- Feb 23, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 23168 | FL | Primary |
Addresses
Primary practice location
13800 Veterans Way
Orlando, FL 32827-7401
Mailing address
3442 Somerset Park Dr
Orlando, FL 32824-7342
Phone (407) 443-5501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23168 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1497511703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3442 SOMERSET PARK DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328247342",
"telephone_number": "407-443-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13800 VETERANS WAY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328277401",
"telephone_number": "407-631-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLABO",
"first_name": "JAMES",
"middle_name": "ELIAS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-23",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "23168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.