| Malabar Family Practice | |
|
1731 Banaghen Dr Melbourne FL 32940-6012 | |
| (614) 404-0972 | |
| Not Available |
| Full Name | Malabar Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1731 Banaghen Dr, Melbourne, Florida |
| Authorized Official Name and Position | Chaithanya Deepthi Buddha (PRESIDENT) |
| Authorized Official Contact | 6144040972 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Malabar Family Practice 1731 Banaghen Dr Melbourne FL 32940-6012 Ph: (614) 404-0972 | Malabar Family Practice 1731 Banaghen Dr Melbourne FL 32940-6012 Ph: (614) 404-0972 |
| NPI Number | 1144842246 |
|---|---|
| Provider Enumeration Date | 05/12/2020 |
| Last Update Date | 07/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144842246 | NPI | - | NPPES |
| 14Y3K | Other | FL | FLORIDA BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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