# MITCHELL ROBERT PETIT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1184628547
- **Gender:** Man
- **Credential:** O.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC 3419 | FL | Yes |

## Other

- **Enumeration date:** 06/13/2005
- **Last updated:** 02/04/2016

## 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 |