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General NPI Number Information
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NPI Number | 1598208977
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Entity Type | Individual
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Provider Name | EARLINE MIZELL
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Gender | Female
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 12/06/2016
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Provider Practice Location Address
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Address Line | 455 DOUGLAS AVE SUITE 2155-4
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2569
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Country | US
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Telephone | 407-682-3900
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Fax | 321-952-0294
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Provider Business Mailing Address
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Address Line | PO BOX 940924
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City | MAITLAND
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State | FL
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Zip | 32794-0924
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Country | US
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Telephone | 407-682-3900
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Fax | 321-952-0294
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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