Individual
DR. GHAITH MITRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP RHEUMATOLOGY DEPT., JACKSONVILLE, FL 32209-6511
(904) 383-1005
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
MD 35636
TN
207RR0500X
Rheumatology Physician
Primary
ME81491
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2794144-00
—
FL
05
—
3870948
—
TN
05
—
854077880A
—
GA
Enumeration date
05/23/2005
Last updated
07/30/2010
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