Healthcare Provider Details

I. General information

NPI: 1831577485
Provider Name (Legal Business Name): JENNIFER DIANE MITRANO PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7999 DR MARTIN LUTHER KING ST N
SAINT PETERSBURG FL
33702-4107
US

IV. Provider business mailing address

300 PINELLAS ST
CLEARWATER FL
33756-3804
US

V. Phone/Fax

Practice location:
  • Phone: 727-578-5335
  • Fax:
Mailing address:
  • Phone: 727-578-5335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS52300
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: