Provider Demographics
NPI:1386600187
Name:MALAGA, BERNARDO FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:BERNARDO
Middle Name:FRANCISCO
Last Name:MALAGA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0878
Mailing Address - Country:US
Mailing Address - Phone:689-223-3898
Mailing Address - Fax:689-223-3898
Practice Address - Street 1:515 E GARDEN ST STE B
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4615
Practice Address - Country:US
Practice Address - Phone:863-588-4775
Practice Address - Fax:863-422-7664
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14902208D00000X
FLACN865208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0021727Medicare UPIN