Provider Demographics
NPI:1063383495
Name:MALALEL, JENNIFER ROSE (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROSE
Last Name:MALALEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WIMBLEDON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2420
Mailing Address - Country:US
Mailing Address - Phone:954-579-0084
Mailing Address - Fax:
Practice Address - Street 1:601 ATLANTIC BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060
Practice Address - Country:US
Practice Address - Phone:954-785-4273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11039286367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife