Provider Demographics
NPI:1114476256
Name:MITCHELL, BRIGITTE
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16913 LAKESIDE DR STE 11
Mailing Address - Street 2:
Mailing Address - City:MONTVERDE
Mailing Address - State:FL
Mailing Address - Zip Code:34756-3230
Mailing Address - Country:US
Mailing Address - Phone:407-544-2351
Mailing Address - Fax:
Practice Address - Street 1:6128 SW 103RD LN
Practice Address - Street 2:
Practice Address - City:BUSHNELL
Practice Address - State:FL
Practice Address - Zip Code:33513-8912
Practice Address - Country:US
Practice Address - Phone:352-457-5755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-30
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care