Mary Mailloux, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME62993 Issued in FL

Practice address

3333 W Commercial Blvd
Ste 210
Ft Lauderdale, FL 33309-3407

Phone

(877) 751-1157

Fax

(919) 425-1596

NPI assigned

May 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Coral Springs, FL
  • NPI 1871542969
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1760485437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4074 SW 101ST AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282205",
            "telephone_number": "954-476-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W COMMERCIAL BLVD",
            "address_2": "STE 210",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093407",
            "telephone_number": "877-751-1157",
            "fax_number": "919-425-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAILLOUX",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME62993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CORE",
            "identifier": "23714",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374172900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha L Mahler
• Holly Mahon, MD
• Kyle John Mahoney, PHARMD, MBA, BCPS
• Maureen Mahoney, R.D.,L.N.
• Natascha Maia, LMT
• Moshe Maiman, PHD
• Shawndra Erica Maine, PSY.D.
• Archana Maini, M.D.
• Tanesha Rashaun Maiten, M.S.W.
• Javier Enrique Maiz

• Emergency Medicine Physician in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.