MEDICARE: DR. BETHANN MAHONEY D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	3436	AZ
2	2084P0802X	Addiction Psychiatry Physician	3436	AZ
3	2084P0800X	Psychiatry Physician	OS12407	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104990217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETHANN MAHONEY D.O.

Provider Business Mailing Address
First Line	:	100 S HARBOR CITY BLVD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1319
Country	:	US
Telephone Number	:	321-259-1662
Fax Number	:	321-259-1223

Provider Business Practice Location Address
First Line	:	100 S HARBOR CITY BLVD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1319
Country	:	US
Telephone Number	:	321-259-1662
Fax Number	:	321-259-1223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	06/10/2020

Similar Medicare Providers

1487815601 — CHRISTAL M DICKUN MD
Practice Location Address:

100 S HARBOR CITY BLVD
MELBOURNE, FL
32901-1319

Practice Phone: 844-856-2585
Practice Fax: 321-259-1223

1407479876 — MORGAN O'SHAUGHNESSY
Practice Location Address:

100 S HARBOR CITY BLVD
MELBOURNE, FL
32901-1319

Practice Phone: 321-266-1404
Practice Fax:

1851998546 — MR. JOHN POWELL LMHC, M.S., NCC
Practice Location Address:

100 S HARBOR CITY BLVD
MELBOURNE, FL
32901-1319

Practice Phone: 802-391-9104
Practice Fax:

1871055350 — MALIA S GAVIGAN APRN
Practice Location Address:

1223 GATEWAY DR
MELBOURNE, FL
32901-2607

Practice Phone: 321-549-0573
Practice Fax: 321-952-2330

1972469476 — OB HOSPITALIST GROUP LLC
Practice Location Address:

1350 HICKORY ST
MELBOURNE, FL
32901-3224

Practice Phone: 864-908-3530
Practice Fax:

1851907828 — TOTAL SPINE & WELLNESS
Practice Location Address:

709 S HARBOR CITY BLVD STE 110
MELBOURNE, FL
32901-1938

Practice Phone: 321-499-4646
Practice Fax:

Directions to “ DR. BETHANN MAHONEY D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.