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General NPI Number Information
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NPI Number | 1215116256
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Entity Type | Individual
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Provider Name | CARLA BRYANT MITCHELL RPH
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Gender | Female
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 2421 N FEDERAL HWY
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City | POMPANO BEACH
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State | FL
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Zip | 33064-6853
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Country | US
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Telephone | 954-781-0778
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Fax | 954-946-6154
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Provider Business Mailing Address
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Address Line | 4356 NW 103RD AVE
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City | SUNRISE
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State | FL
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Zip | 33351-8200
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Country | US
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Telephone | 954-648-9416
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Fax | 954-578-2433
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS29463
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License Number State | FL
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