Individual ProviderRoman Luis MalagonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9535 SW 187th St, Cutler Bay, FL 33157-7861(786) 287-3126PECOS EnrollmentBased on the most recent information from CMS, provider Roman Luis Malagon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1205307808Provider TypeIndividualFull NameLuis Malagon, RomanTitleMr.CredentialMSN, APRNGenderMaleSole ProprietorYesEnumeration Date12/9/2018Last Updated10/26/2022Contact InformationPractice LocationPractice Address9535 SW 187th St, Cutler Bay, FL 33157-7861Phone(786) 287-3126Fax(786) 549-0172Mailing LocationMailing Address9535 SW 187th St, Cutler Bay, FL 33157-7861Phone(786) 287-3126Fax(786) 549-0172Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11000237Florida