SearchFlorida332H00000X

Edward Mitchell, LDO

NPI 1811139462 · on the registry since 2009 · sole proprietor

Practice

Address
4100 S Ferdon Blvd Ste B5
Crestview, FL 32536
Phone
(850) 758-0474
Fax
(850) 682-0057
Organisation at this address
Triple E Ot Inc
Prime Therapy, Inc
Cabana Eyes Optical
Kids Talk Place Llc
Michelle H Stevens Md Pa
Inferred from a shared address, not stated in the registry.
Clinicians at this address
35

Additional practice sites

  • 4724 Whitewater Ln, Crestview, FL

Registry record

Primary taxonomy
332H00000X
332H00000X
Also registered as
156FC0801X
156FX1800X
156FX1800X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-10-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida