Provider Demographics
NPI:1194855049
Name:MITCHELL, LYNNE E
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:E
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 1:222 BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-2006
Mailing Address - Country:US
Mailing Address - Phone:407-298-2062
Mailing Address - Fax:407-298-2062
Practice Address - Street 1:222 BAYSHORE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-2006
Practice Address - Country:US
Practice Address - Phone:407-298-2062
Practice Address - Fax:407-298-2062
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant