RONALD MARTIN MALL DO NPI 1083648703

NPI Information

  • NPI: 1083648703
  • Provider Name: RONALD MARTIN MALL, DO
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3800 EAST BAY DRIVE
    EAST BAY MEDICAL CENTER
    LARGO, FL
    ZIP 33771
  • Phone: (727) 539-0505

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NPI Details

Ronald Martin Mall, DO is a general practice in Largo, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Ronald Martin Mall, DO NPI is 1083648703. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3800 EAST BAY DRIVE
EAST BAY MEDICAL CENTER
LARGO, FL
ZIP 33771
Phone: (727) 539-0505
Fax: (727) 394-1804

The NPI 1083648703 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Annual depression screening, 15 minutes (HCPCS:G0444)

The enumeration date for this NPI number is 7/10/2006 and was last updated on 12/27/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeOS0003675FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1267070OTHERAVMED
2E32135MEDICARE UPIN
382081WMEDICARE ID-TYPE UNSPECIFIED
42337655OTHERAETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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