MEDICARE: TONI ANITA MITCHELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME40152	FL

General Provider Information

NPI Number	:	1013935618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI ANITA MITCHELL MD

Provider Business Mailing Address
First Line	:	4200 W CYPRESS ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-4156
Country	:	US
Telephone Number	:	813-830-6905
Fax Number	:	813-314-2045

Provider Business Practice Location Address
First Line	:	4200 W CYPRESS ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-4156
Country	:	US
Telephone Number	:	813-830-6905
Fax Number	:	813-314-2045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/08/2007

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