Melvin Mallari, L.M.T, P.T.A

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA26759 Issued in FL

Practice address

3816 Waterside Dr
Orange Park, FL 32073

Phone

(904) 802-1421

NPI assigned

Apr 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1619294725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 WATERSIDE DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320736982",
            "telephone_number": "904-802-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 WATERSIDE DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-802-1421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4591 Cove Dr Apt 22-106",
            "address_purpose": "LOCATION",
            "city": "Belle Isle",
            "state": "FL",
            "postal_code": "328122944",
            "country_code": "US",
            "telephone_number": "904-899-3924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLARI",
        "first_name": "MELVIN",
        "name_prefix": "Mr.",
        "credential": "L.M.T, P.T.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26759",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2127861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sterling Mahan, H.A.S.
• Ibrahim Magdi Gafar Mahgoub, MD
• Tiffany N Major, APRN
• Yan G Makeyev, MD
• Shilpa Malik, DO
• Noelle Brittany Malone
• Julie Tutak Maly, ARNP
• Laura M Manassa, MACP
• Amanda Nicole Mancino, APRN
• Mandarin Pain Solutions, PLLC

• Physical Therapy Assistant in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.