Individual
JOSHUA SHANE MALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-4200
Mailing address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14223901-9934
UT
Other
Enumeration date
05/19/2025
Last updated
05/28/2025
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