Individual
DR. ANDREW SEAN MALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1330 S FORT HARRISON AVE, CLEARWATER, FL 33756-3313
(727) 216-0700
(727) 216-0704
Mailing address
2515 COUNTRYSIDE BLVD, SUITE E, CLEARWATER, FL 33763-1603
(727) 216-0700
(727) 216-0704
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
OS12619
FL
207Y00000X
Otolaryngology Physician
OT013216
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010925000
—
FL
01
—
OS12619
STATE OF FLORIDA MEDICAL LICENSE
FL
Enumeration date
06/25/2009
Last updated
05/14/2024
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