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Organization
LEON WAYNE MITCHELL MD PA
Active
Organization
LEON WAYNE MITCHELL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA MARIE KLAY (OFFICE MANAGER)
(813) 971-2300
Entity
Organization
Contact information
Practice address
3010 E 138TH AVE, SUITE 100, TAMPA, FL 33613-3904
(813) 971-2300
(813) 971-2311
Mailing address
3010 E 138TH AVE, SUITE 100, TAMPA, FL 33613-3904
(813) 971-2300
(813) 971-2311
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
ME13022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME13022
FL STATE LICENSE
FL
Enumeration date
05/08/2008
Last updated
05/08/2008
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