Provider Demographics
NPI:1073903274
Name:MITCHELL, DELLA (PHARM D)
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:DANIA
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4005
Mailing Address - Country:US
Mailing Address - Phone:954-920-0477
Mailing Address - Fax:
Practice Address - Street 1:202 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DANIA
Practice Address - State:FL
Practice Address - Zip Code:33004-4005
Practice Address - Country:US
Practice Address - Phone:954-920-0477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist