MEDICARE: ALAN L MITCHELL MD PA

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	207W00000X	Ophthalmology Physician	ME57319	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10754	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053593194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN L MITCHELL MD PA

Provider Business Mailing Address
First Line	:	22023 STATE ROAD 7
Second Line	:	SUITE 102
City	:	BOCA RATON
State	:	FL
Zip	:	33428-3401
Country	:	US
Telephone Number	:	561-451-0655
Fax Number	:	561-451-2660

Provider Business Practice Location Address
First Line	:	22023 STATE ROAD 7
Second Line	:	SUITE 102
City	:	BOCA RATON
State	:	FL
Zip	:	33428-3401
Country	:	US
Telephone Number	:	561-451-0655
Fax Number	:	561-451-2660

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALAN LEWIS MITCHELL I
Credential	:	M.D.
Telephone Number	:	561-451-0655

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	12/17/2007

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