Individual
MARY T MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
14050 NW 14TH ST STE 190, SUNRISE, FL 33323-2851
(800) 424-3672
(954) 377-3042
Mailing address
14050 NW 14TH ST STE 190, SUNRISE, FL 33323-2851
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9162698
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BCBS
FL
05
—
PENDING
—
FL
Enumeration date
07/08/2010
Last updated
03/17/2018
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