Individual
DR. HOLLY MAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 S ANDREWS AVE, BROWARD PEDIATRICS ED, FT LAUDERDALE, FL 33316-2510
(954) 355-4400
Mailing address
2545 RIVERLANE TER, FT LAUDERDALE, FL 33312-4765
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME64987
FL
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
ME64987
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037341199
—
FL
01
—
23458
MEDICARE CORE
FL
Enumeration date
09/26/2005
Last updated
07/11/2012
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