Individual
DR. CORDELL MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
974 DOUGLAS AVE, SUITE 102, ALTAMONTE SPRINGS, FL 32714-5203
(407) 862-1550
(407) 862-6042
Mailing address
974 DOUGLAS AVE, SUITE 102, ALTAMONTE SPRINGS, FL 32714-5203
(407) 862-1550
(407) 862-6042
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME 0053063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048709100
—
FL
01
—
07445
BCBS PROVIDER I.D.
FL
01
—
101530
AVMED PROVIDER I.D.
FL
01
—
197920
HEALTHEASE PROVIDER I.
FL
Enumeration date
05/18/2006
Last updated
01/09/2019
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