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NPI Code Detail

MEDICARE: SOPHONIE MITIL APRN

MEDICARE: SOPHONIE MITIL APRN
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11042611FL

General Provider Information

NPI Number : 1760208912
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHONIE MITIL APRN
Provider Business Mailing Address
First Line : 525 TECHNOLOGY PARK STE 109
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-7107
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 525 TECHNOLOGY PARK STE 109
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-7107
Country : US
Telephone Number : 407-647-2346
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2024
Last Update Date : 06/24/2026

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Directions to “ SOPHONIE MITIL APRN” Practice Location

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