Provider Demographics
NPI:1548510225
Name:MALUDA, FRANK JOSEPH JR (RPH)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:JOSEPH
Last Name:MALUDA
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11011 NW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5704
Mailing Address - Country:US
Mailing Address - Phone:954-752-4711
Mailing Address - Fax:
Practice Address - Street 1:11011 NW 19TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-5704
Practice Address - Country:US
Practice Address - Phone:954-752-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005587100Medicaid