Healthcare Provider Details

I. General information

NPI: 1619429495
Provider Name (Legal Business Name): CARUSO-DOERR INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5327 COMMERCIAL WAY STE B108
SPRING HILL FL
34606-1499
US

IV. Provider business mailing address

5327 COMMERCIAL WAY STE B108
SPRING HILL FL
34606-1499
US

V. Phone/Fax

Practice location:
  • Phone: 352-616-0233
  • Fax: 352-616-0236
Mailing address:
  • Phone: 352-616-0233
  • Fax: 352-616-0236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS8846
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN M MITCHELL
Title or Position: PHYSICIAN
Credential: DO
Phone: 352-616-0233