Provider Demographics
NPI:1386916062
Name:COMMUNITY MEDICAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:COMMUNITY MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MALY
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-593-0031
Mailing Address - Street 1:5176 WILLIAM SULLIVAN CIR
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34604-8227
Mailing Address - Country:US
Mailing Address - Phone:352-593-0031
Mailing Address - Fax:
Practice Address - Street 1:5176 WILLIAM SULLIVAN CIR
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34604-8227
Practice Address - Country:US
Practice Address - Phone:352-593-0031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP912712363LA2200X
FLARNP3301752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty