MEDICARE: DR. BYRON L MITCHELL D.D.S.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	4832	FL

General Provider Information

NPI Number	:	1619175577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BYRON L MITCHELL D.D.S.

Provider Business Mailing Address
First Line	:	4885 NW 7TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127-2303
Country	:	US
Telephone Number	:	305-751-4889
Fax Number	:

Provider Business Practice Location Address
First Line	:	4885 NW 7TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127-2303
Country	:	US
Telephone Number	:	305-751-4889
Fax Number	:

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	07/08/2007

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