MEDICARE: OLUWAKEMI MITCHELL DNP, PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11034528	FL

General Provider Information

NPI Number	:	1861222580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWAKEMI MITCHELL DNP, PMHNP

Provider Business Mailing Address
First Line	:	22356 CHEROKEE ROSE PL
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-3111
Country	:	US
Telephone Number	:	813-537-8710
Fax Number	:	813-537-8710

Provider Business Practice Location Address
First Line	:	22356 CHEROKEE ROSE PL
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-3111
Country	:	US
Telephone Number	:	813-469-4215
Fax Number	:	813-537-8710

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

Provider Enumeration Date	:	08/06/2024
Last Update Date	:	06/18/2025

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