Active NPI
Debra Spano Mahoney
- Optician
- Fort Pierce, FL
National Provider Identifier
1750850111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO5164
- Practice address
- 2201 S 10TH St
Fort Pierce, FL 34950-5382 - Phone
- (772) 461-3890
- Fax
- (772) 468-2134
- NPI assigned
- Nov 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO5164 | FL | Primary |
Addresses
Primary practice location
2201 S 10TH St
Fort Pierce, FL 34950-5382
Mailing address
2201 S 10TH St
Fort Pierce, FL 34950-5382
Phone (772) 461-3890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO5164 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542240000000",
"number": "1750850111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 S 10TH ST",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349505382",
"telephone_number": "772-461-3890",
"fax_number": "772-468-2134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 S 10TH ST",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349505382",
"telephone_number": "772-461-3890",
"fax_number": "772-468-2134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "DEBRA",
"middle_name": "SPANO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-15",
"last_updated": "2018-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO5164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.