Irene Elaine Malesic, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

36753 Issued in FL

Practice address

12412 San Jose Blvd
Suite 104
Jacksonville, FL 32223-8620

Phone

(904) 292-4755

Fax

(904) 292-9243

NPI assigned

Sep 15, 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

Other identifiers 1

Other names 1

• Ms. Irene Malesic Pezzuto Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pediatric Associates at Argyle PA

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1063557460
  NPD (past)
• Pediatric Associates at Argyle PA

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1144495466
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972609345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12412 SAN JOSE BLVD",
            "address_2": "SUITE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238620",
            "telephone_number": "904-292-4755",
            "fax_number": "904-292-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12412 SAN JOSE BLVD",
            "address_2": "SUITE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238620",
            "telephone_number": "904-292-4755",
            "fax_number": "904-292-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALESIC",
        "first_name": "IRENE",
        "middle_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "36753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "15570",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRENE",
            "last_name": "PEZZUTO",
            "middle_name": "MALESIC",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christine Maldonado
• Isaac S Maldonado
• Ivan Maldonado
• Javier Maldonado, DDS
• Roxana Maldonado
• Alina Zofia Maleski, MD
• Nitika Malhotra, M.D
• Naveen J Maliakkal, MD
• Awais Ahmed Malik, M.D.
• Farah Malik, M.D.

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.