William J. Mallon, MD

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

WILLIAM J. MALLON, MD

Doing business as

Center for Advanced Eye Care

Practice address

1707 S 25TH St
Fort Pierce, FL 34947-4709

Phone

(772) 299-1404

NPI assigned

Mar 6, 2024

Organization subpart

Yes

Parent organization

WILLIAM J. MALLON, MDAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle Malcolm

Title

RPHT

Phone

(772) 299-1404

Specialties & licenses 1

Addresses

Other names 1

• Center for Advanced Eye Care Doing business as

Tax ID family

William J Mallon MD PA3 organizations share this tax ID, including this one

Part of

William J Mallon MD PA

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• William J. Mallon, MD

  dba Advanced Optical

  • Eyewear Supplier
  • Vero Beach, FL
  • NPI 1376569038
  NPD tax ID
• William J. Mallon, MD

  dba Center for Advanced Eye Care

  • Ophthalmology Physician
  • Vero Beach, FL
  • NPI 1649353582
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William J. Mallon, M.D.

  • Ophthalmology Physician
  • Vero Beach, FL
  • NPI 1114976479
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1336906221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 US HIGHWAY 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604511",
            "telephone_number": "772-299-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474709",
            "telephone_number": "772-299-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J. MALLON, MD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM J. MALLON, MD",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "MALCOLM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "RPHT",
        "authorized_official_telephone_number": "772-299-1404"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Advanced Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Wilks
• Wayne Anthony Wilks
• William a. Olivos, OD, PA
• William B King MD PA
• William H Hood MD PA
• Williams Receptive P.a. (ADHD Advisor)
• Alisha Valtrisse Williams, MD
• Ingrid Williams, OTR/L
• Jennifer Denise Williams
• Thomas Benjamin Williams, RPH

• Non-Pharmacy Dispensing Site in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.