MICHAEL J MALLIS (NPI# 1477567642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477567642 |
| Entity Type | Individual |
| Full Name | MICHAEL J MALLIS |
| Credential | D.O. |
| Practice Address |
4651 Sheridan St Ste 350 Hollywood FL 33021-3425 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9542768559 |
| Practice Fax Number | 9549669762 |
| Mailing Telephone | 9542765685 |
| Mailing Fax Number | 9549857074 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | OS8804 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 274719700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 20803 Biscayne Blvd Ste 204, Aventura, FL 331801429 | 9548444480 | 9544475344 |
| Street Address |
4651 SHERIDAN ST STE 350 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-3425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467901397 | Elizabeth Mcelhaney | Dietitian, Registered | 4651 Sheridan St Ste 350, Hollywood, FL 33021-3425 | 2016-10-04 |
| 1710124912 | Brett Amy Chusid | Physician Assistant | 4651 Sheridan St Ste 350, Hollywood, FL 33021-3425 | 2009-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649834169 | Florida Comprehensive Health Management LLC | Surgery | 3475 Sheridan St Ste 101, Hollywood, FL 33021-3633 | 2019-04-30 |
| 1376965459 | Ira Glazer | Surgery | 524 N Rainbow Dr, Hollywood, FL 33021-6060 | 2014-01-09 |
| 1780954859 | Michael Parmer | Surgery | 2301 S Ocean Dr, Apt. 504, Hollywood, FL 33019-2621 | 2012-01-06 |
| 1477874907 | Courtney Michelle Edwards | Surgery | 1150 N 35th Ave Ste 200, Hollywood, FL 33021 | 2010-06-18 |
| 1710178116 | Narciso Lino Gomez | Surgery | 3475 Sheridan St Ste 201, Hollywood, FL 33021-3659 | 2007-08-09 |
| 1932319076 | Yin-kan Hwee | Surgery | 1201 N 35th Ave, Suite 200, Hollywood, FL 33021-5468 | 2007-05-23 |
| 1821002171 | Alexander Marmureanu | Surgery | 6253 Hollywood Blvd Apt 1108, Hollywood, CA 90028-8261 | 2006-07-29 |
| 1760400030 | Robert B Donoway | Surgery | 4000 Hollywood Blvd, Presidential Circle, Suite 160 North, Hollywood, FL 33021-6751 | 2006-07-17 |
| 1770540494 | Luis Asanza | Surgery | 4811 Hollywood Blvd, Suite C, Hollywood, FL 33021 | 2006-04-27 |
| 1568428266 | Steven Magilen | Surgery | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019 | 2006-04-22 |
| Find all providers in HOLLYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.