MEDICARE: CORTNEY LYNN MITCHELL-ENGLAND CF-SLP

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
1	235Z00000X	Speech-Language Pathologist	SZ6548	FL

General Provider Information

NPI Number	:	1427470335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORTNEY LYNN MITCHELL-ENGLAND CF-SLP

Provider Business Mailing Address
First Line	:	1200 W STATE ROAD 434
Second Line	:	SUITE #124
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4986
Country	:	US
Telephone Number	:	407-353-2101
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 E 4TH AVE
Second Line	:	SUITE #124
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-5550
Country	:	US
Telephone Number	:	407-353-2101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2014
Last Update Date	:	01/11/2014

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