Healthcare Provider Details

I. General information

NPI: 1356373484
Provider Name (Legal Business Name): SHARON MARIE MAHONEY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7503 N. MILITARY TRAIL
WPB FL
33410
US

IV. Provider business mailing address

5003 PIER DR
GREENACRES FL
33463-2327
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-8262
  • Fax:
Mailing address:
  • Phone: 561-357-8917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: