Imran Malik MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME107296 Issued in FL

Legal business name

IMRAN MALIK MD LLC

Doing business as

Family Medicine Clinic

Practice address

8515 S US Highway 1
Suite 3
Port Saint Lucie, FL 34952-3346

Phone

(772) 380-4042

Fax

(772) 380-4043

NPI assigned

Sep 26, 2011

Last updated

Nov 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Imran M Malik, MDNPI 1760651285

Title

Managing Member

Phone

(772) 380-4042

Specialties & licenses 1

Addresses

Other names 1

• Family Medicine Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Imran Mushtaq Malik, M.D.

  • Family Medicine Physician
  • Port St Lucie, FL
  • NPI 1760651285
  Medicare reassignment Authorized official
• Alexia Anna Pizzarro, FNP-C

  • Nurse Practitioner
  • Port Saint Lucie, FL
  • NPI 1780364935
  Medicare reassignment NPD

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1649553793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8515 S US HIGHWAY 1",
            "address_2": "SUITE 3",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523346",
            "telephone_number": "772-380-4042",
            "fax_number": "772-380-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8515 S US HIGHWAY 1",
            "address_2": "SUITE 3",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523346",
            "telephone_number": "772-380-4042",
            "fax_number": "772-380-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMRAN MALIK MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "772-380-4042",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME107296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.