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General NPI Number Information
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NPI Number | 1447249180
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Entity Type | Individual
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Provider Name | MARY ELLA MAHONEY PHARM.D., BCOP
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Gender | Female
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Dates
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Enumeration Date | 10/16/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 S ORANGE AVE MP 720
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City | ORLANDO
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State | FL
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Zip | 32806-2134
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Country | US
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Telephone | 321-843-1014
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Fax | 321-841-6471
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Provider Business Mailing Address
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Address Line | 8701 COCO PLUM PL
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City | ORLANDO
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State | FL
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Zip | 32827-6860
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Country | US
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Telephone | 321-843-1014
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Fax | 321-841-6471
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS36340
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License Number State | FL
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