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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

AUTUM MARIE MALLICK

Active Sole Proprietor

AUTUM MARIE MALLICK is a Podiatric Surgery healthcare provider located in HOLT, Florida. NPI 1578108627 is currently active in the NPPES registry. Verify at CMS.

Podiatric Surgery · HOLT, FL

Registration Details

NPI Number
1578108627
Provider Type
Individual
Gender
Female
NPI Issued
Nov 13, 2019 (6.5688352360693 yrs)
Last Updated
Nov 14, 2019
Sole Proprietor
Yes

Practice Information

Address
7165 TEE DON CT
HOLT, FL, 325648925
Browse FL providers · Browse ZIP 32564
Phone
8503139846
Primary Specialty
Podiatric Surgery
3747A0650X
Additional Specialty
Podiatric Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.