Provider Demographics
NPI:1730382110
Name:MAHONEY, MATTHEW H (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:H
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7995 66TH ST N STE B
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2163
Mailing Address - Country:US
Mailing Address - Phone:727-530-0920
Mailing Address - Fax:727-827-7139
Practice Address - Street 1:7995 66TH ST N STE B
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2163
Practice Address - Country:US
Practice Address - Phone:727-530-0920
Practice Address - Fax:727-827-7139
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88148207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology