BRIAN JOSEPH MALLETTE (NPI# 1669455291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669455291 |
| Entity Type | Individual |
| Full Name | BRIAN JOSEPH MALLETTE |
| Credential | D.P.M. |
| Practice Address |
200 S Harbor City Blvd Suite 102 Melbourne FL 32901-1384 |
| Practice Telephone | 3217280117 |
| Practice Fax Number | 3217280151 |
| Mailing Telephone | 3217280117 |
| Mailing Fax Number | 3217280151 |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2015-12-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | PO2692 | FL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AETNA | 5532704 | 01 |
| FL | BLUE CROSS BLUE SHIELD | 65643 | 01 |
| FL | CIGNA | 9415057001 | 01 |
| FL | AETNA | 2605728 | 01 |
| FL | 261086800 | 05 | |
| FL | RAILROAD MEDICARE | 480031393 | 01 |
| Street Address |
200 S HARBOR CITY BLVD SUITE 102 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-1384 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073755963 | Brian J Mallette Dpm LLC | Podiatrist | 200 S Harbor City Blvd, Suite302, Melbourne, FL 32901-1384 | 2009-03-24 |
| 1861633463 | Claudia R. Mallette | Podiatrist | 200 S Harbor City Blvd, Suite 302, Melbourne, FL 32901-1384 | 2009-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114465515 | Foot and Ankle Associates of Brevard LLC | Podiatrist | 4020 Fair Point Ln, Melbourne, FL 32934-8436 | 2017-02-06 |
| 1609201227 | Patricia A Russo | Podiatrist | 2958 Ingram Ave, Melbourne, IA 50162-9559 | 2013-09-13 |
| 1710096862 | Daniel Albert Cohen | Podiatrist | 7730 N Wickham Rd, Suite 103, Melbourne, FL 32940 | 2006-08-30 |
| 1619986429 | Brian Stanley Wieszbicki | Podiatrist | 1375 Cypress Trace Dr, Melbourne, FL 32940-1623 | 2006-08-08 |
| 1437181666 | Stanley Ira Gabe | Podiatrist | 129 W Hibiscus Ave, Suite C, Melbourne, FL 32901 | 2006-07-07 |
| 1174506877 | Briant G Moyles Dpm Pa | Podiatrist | 211 E New Haven Ave, Melbourne, FL 32901-4503 | 2005-11-28 |
| 1306273545 | Iowa Podiatry Care, Inc. | Podiatrist | 2958 Ingram Ave, Melbourne, IA 50162-9559 | 2013-10-02 |
| 1558701243 | Jessica Ann Ortega Wilson | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2013-06-27 |
| 1184064834 | Thomas Charles Wilson | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2013-06-26 |
| 1457589244 | Jared Briant Moyles | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2009-06-30 |
| Find all providers in MELBOURNE | ||||
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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.