Provider Demographics
NPI:1033201629
Name:MITCHELL, PAUL E (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:E
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10537 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1105
Mailing Address - Country:US
Mailing Address - Phone:727-376-8404
Mailing Address - Fax:727-376-8552
Practice Address - Street 1:31860 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3713
Practice Address - Country:US
Practice Address - Phone:727-787-6335
Practice Address - Fax:727-772-2160
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2015-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME76043208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255029600Medicaid
FL255029600Medicaid
FLG78965Medicare UPIN