Healthcare Provider Details

I. General information

NPI: 1750228532
Provider Name (Legal Business Name): CHELSEA MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6551 N ORANGE BLOSSOM TRL
MOUNT DORA FL
32757-7013
US

IV. Provider business mailing address

125 ARAGON AVE
UMATILLA FL
32784-9518
US

V. Phone/Fax

Practice location:
  • Phone: 352-630-2661
  • Fax:
Mailing address:
  • Phone: 352-630-2661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: