MEDICARE: LINDA C MITCHELL PT

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	2251P0200X	Pediatric Physical Therapist		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y2512	OTHER	FL	BLUE CROSS PROVIDER
2	35106	OTHER	FL	DEPT MEDICAL QUAL ASSURAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770702433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA C MITCHELL PT

Provider Business Mailing Address
First Line	:	8340 65TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-7103
Country	:	US
Telephone Number	:	772-538-2351
Fax Number	:

Provider Business Practice Location Address
First Line	:	8340 65TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-7103
Country	:	US
Telephone Number	:	772-538-2351
Fax Number	:

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

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/08/2007

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Directions to “ LINDA C MITCHELL PT” Practice Location

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