MEDICARE: DR. NEETA MITROO 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	207L00000X	Anesthesiology Physician	35043446M	OH
2	207L00000X	Anesthesiology Physician	ME98416	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	15403	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1760477111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEETA MITROO MD

Provider Business Mailing Address
First Line	:	PO BOX 551420
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33355-1420
Country	:	US
Telephone Number	:	800-243-3839
Fax Number	:	855-851-4405

Provider Business Practice Location Address
First Line	:	4725 N. FEDERAL HIGHWAY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4603
Country	:	US
Telephone Number	:	954-771-8000
Fax Number	:	954-776-3270

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	08/30/2012

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Directions to “ DR. NEETA MITROO MD” Practice Location

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