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DR. RANDOLPH BARRET MAHONEY PA-C, PHD
NPI 1669464236
Physician Assistant in Jacksonville, FL

Active since August 18, 2005
1541 RIVERSIDE AVE, JACKSONVILLE, FL 32204(904) 354-4488(904) 634-8912 Get Directions Write a Review

NPPES record last updated: November 14, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Randolph Barret Mahoney Pa-c, Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RANDOLPH BARRET MAHONEY PA-C, PHD (NPI 1669464236) is an individual physician assistant in Jacksonville, Florida, licensed in Florida (PA 9101713) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1669464236
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDR. RANDOLPH BARRET MAHONEYCredential: PA-C, PHD
Location Address1541 RIVERSIDE AVEJacksonville, FL 32204-4124
Mailing AddressPo Box 42Jacksonville, FL 32210-0042 · (904) 354-4488 · Fax (904) 634-8912
Phone(904) 354-4488
Fax(904) 634-8912
Sole ProprietorNo
Enumeration DateAugust 18, 2005
Last NPPES UpdateNovember 14, 2007
✔ NPI 1669464236 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA 9101713
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA 9101713 (FL)
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License PA 9101713 (FL)
1541 RIVERSIDE AVE, Jacksonville, FL 32204
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Other Identifiers 1

Medicare PINU6699YFL

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRENT ROBERT TAYLOR M.D.
Dermatology (MOHS-Micrographic Surgery)
1541 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (866) 400-3376
NORTH FLORIDA DERMATOLOGY ASSOCIATES, PA
Specialist
1541 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 354-4488

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randolph Mahoney's NPI number?

The NPI number for Randolph Mahoney is 1669464236. It was assigned to this individual provider in the NPPES registry on August 18, 2005.

Where is Randolph Mahoney located?

Randolph Mahoney practices at 1541 Riverside Ave, Jacksonville, FL 32204. The listed phone number is (904) 354-4488.

What is Randolph Mahoney's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Randolph Mahoney was last updated on November 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.