Individual
MITCHELL ROBERT PETIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2000 66TH ST N, ST PETERSBURG, FL 33710-4710
(727) 341-1987
(727) 347-7297
Mailing address
3115 W SWANN AVE, STE 200, TAMPA, FL 33609-4617
(813) 908-2020
(813) 908-2133
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
CLARITY 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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