Healthcare Provider Details

I. General information

NPI: 1124958186
Provider Name (Legal Business Name): ROBERT CHRISTOPHER MCMAHON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3264 HUNTINGTON
WESTON FL
33332-1851
US

IV. Provider business mailing address

3264 HUNTINGTON
WESTON FL
33332-1851
US

V. Phone/Fax

Practice location:
  • Phone: 954-778-9412
  • Fax:
Mailing address:
  • Phone: 954-778-9412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY002966
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: