Provider Demographics
NPI:1548475791
Name:MALAVE, VICTOR BRIAN (MD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:BRIAN
Last Name:MALAVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MANSIONES DE LOS ARTESANOS CALLE CEREZO #14
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771
Mailing Address - Country:US
Mailing Address - Phone:787-207-1745
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL GENERAL MENONITA MEDICAL AFFAIRS OFFICE
Practice Address - Street 2:STANLEY MILLER STREET
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16315208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery