Individual
MARY ROSE BALUNOS MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2 TAMPA GENERAL CIR, 2ND FLOOR, TAMPA, FL 33606-3603
(813) 259-8700
(813) 250-2101
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
ARNP9250094
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9250094
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004224300
—
FL
01
—
Y09A1
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/19/2011
Last updated
09/09/2013
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