Individual
JOHN D MALLONEE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2716 S US HIGHWAY 1, FORT PIERCE, FL 34982-5919
(772) 467-0605
Mailing address
2716 S US HIGHWAY 1, FORT PIERCE, FL 34982-5919
(772) 467-0605
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0021825
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058484300
—
FL
Enumeration date
07/28/2006
Last updated
12/22/2016
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