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NPI Code Detail

MEDICARE: ANGELA MICHELLE MITCHELL CRNA

MEDICARE: ANGELA MICHELLE MITCHELL CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistARNP1095252FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1430055965OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3G1221OTHERFLBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295710689
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA MICHELLE MITCHELL CRNA
Provider Business Mailing Address
First Line : PO BOX 862506
Second Line :
City : ORLANDO
State : FL
Zip : 32886-2506
Country : US
Telephone Number : 913-754-0467
Fax Number : 913-754-0467
Provider Business Practice Location Address
First Line : 2901 W SWANN AVE
Second Line :
City : TAMPA
State : FL
Zip : 33609-4056
Country : US
Telephone Number : 913-754-0467
Fax Number : 913-341-5797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2005
Last Update Date : 01/30/2009

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Directions to “ ANGELA MICHELLE MITCHELL CRNA” Practice Location

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