Kylisha J Mallard in Fort Lauderdale - Physician Assistant
Kylisha J Mallard - NPI 1740200468
Kylisha J Mallard is a Physician Assistant in Fort Lauderdale, Florida. Kylisha J Mallard practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kylisha J Mallard is 1740200468. The last update date is 2010-10-01.
Kylisha J Mallard's current location address is Po Box 551420, Fort Lauderdale, Florida. You can contact this provider via phone number 8002433839 and fax number 9548392569. The mailing address for Kylisha J Mallard is Po Box 551420, Fort Lauderdale, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kylisha J Mallard |
|---|---|
| Address | Po Box 551420, Fort Lauderdale, Florida |
| Phone Number | 8002433839 |
| Fax Number | 9548392569 |
| Sole Proprietor | N |
| Credentials | AA |
NPI Number Detail
| NPI Number | 1740200468 |
|---|---|
| Provider Enumeration Date | 2006-07-19 |
| Last Updated Date | 2010-10-01 |
Provider Mailing Address Detail
| Address | Po Box 551420 |
|---|---|
| City | Fort Lauderdale |
| State | Florida (FL) |
| Post Code | 333551420 |
| Phone Number | 8002433839 |
| Fax Number | 9548392569 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 4593 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 760751927C | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Kylisha J Mallard by the Centers for Medicare & Medicaid Services?
The Kylisha J Mallard has been issued the NPI (National Provider Identifier) 1740200468 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Kylisha J Mallard is geographically located?
The Kylisha J Mallard is physically situated at the following location: Po Box 551420, Fort Lauderdale, FL, 333551420.
What is Kylisha J Mallard's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kylisha J Mallard's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
On what date did the Kylisha J Mallard receive its 1740200468 assignment from the Centers for Medicare & Medicaid Services?
The Kylisha J Mallard was assigned its 1740200468 by the Centers for Medicare & Medicaid Services on 2006-07-19.
As of what date were the Kylisha J Mallard's details last updated?
The information pertaining to the Kylisha J Mallard, including its address, specialty, and other details, was most recently updated on 2010-10-01.