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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