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Individual
MITCHELL ROBERT PETIT
Active
Individual
MITCHELL ROBERT PETIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 3419
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11436
SPECTERA
FL
01
—
261355
COLE VISION PLAN
FL
01
—
3419
ECPA
FL
01
—
410001004
HUMANA
FL
01
—
487101
NVA
FL
01
—
593651926
ALLIED EYECARE
FL
05
—
620670100
—
FL
01
—
VFL000856
AVESIS
FL
Enumeration date
06/13/2005
Last updated
02/04/2016
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