| Organization Name: | VANCE J MALONEY III MD PA |
| NPI Number: | 1144402199 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VANCE J MALONEY (OWNER) |
| Mailing Address: | 1315 Hickory Dr Longwood |
| State: | FL US |
| Postal Code: | 327795844 |
| Phone Number: | 4077010012 |
| Fax Number: | |
| NPI Enumeration Date: | 12/01/2007 |
| NPI Last Update Date: | 11/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 24866 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |