Provider Demographics
NPI:1679067417
Name:MALINIS, EDGARDO GABRIEL JR (RRT)
Entity type:Individual
Prefix:MR
First Name:EDGARDO
Middle Name:GABRIEL
Last Name:MALINIS
Suffix:JR
Gender:M
Credentials:RRT
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Mailing Address - Street 1:6551 PARK OF COMMERCE BLVD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-8218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5200 E RANDOLPH CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-2522
Practice Address - Country:US
Practice Address - Phone:757-575-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
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Provider Licenses
StateLicense IDTaxonomies
VA0117008145227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered