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General NPI Number Information
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NPI Number | 1265509541
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Entity Type | Individual
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Provider Name | JOHN GERARD MAHONEY PT
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 86 SE 4TH AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33483-4514
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Country | US
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Telephone | 561-330-7829
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 E ATLANTIC AVE APT. B
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City | DELRAY BEACH
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State | FL
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Zip | 33483-6914
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Country | US
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Telephone | 561-703-5646
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 11137
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License Number State | FL
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