Provider Demographics
NPI:1558532275
Name:MALKA, JONATHAN M (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:M
Last Name:MALKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 NE MIAMI GARDENS DR STE 3242
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5301
Mailing Address - Country:US
Mailing Address - Phone:305-741-5055
Mailing Address - Fax:305-488-5517
Practice Address - Street 1:1728 NE MIAMI GARDENS DR STE 3242
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-5301
Practice Address - Country:US
Practice Address - Phone:305-741-5055
Practice Address - Fax:305-317-5239
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1074082080P0201X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003703500Medicaid
CO27608875Medicaid
CO304967Medicare PIN