Provider Demographics
NPI:1033166277
Name:MITCHELL, JAMIE C (MD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:C
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 WEBB RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3219
Mailing Address - Country:US
Mailing Address - Phone:813-972-0000
Mailing Address - Fax:888-481-1487
Practice Address - Street 1:5959 WEBB RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3219
Practice Address - Country:US
Practice Address - Phone:813-972-0000
Practice Address - Fax:888-481-1487
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219190208600000X
OH90162208600000X
FLME121156208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery