Individual
BLAINE PARRISH MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 437-4800
(954) 437-6628
Mailing address
500 N HIATUS RD STE 200, PEMBROKE PINES, FL 33026-5213
(954) 437-4800
(954) 437-6628
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
H77682
MD
2085R0202X
Diagnostic Radiology Physician
Primary
OS9735
FL
Other
Enumeration date
07/13/2006
Last updated
12/16/2021
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