Provider Demographics
NPI:1760564876
Name:MITZNER, ANN C (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:C
Last Name:MITZNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 TRUMAN AVE
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-7252
Mailing Address - Country:US
Mailing Address - Phone:305-294-4004
Mailing Address - Fax:305-294-2197
Practice Address - Street 1:1511 TRUMAN AVE
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-7252
Practice Address - Country:US
Practice Address - Phone:305-294-4004
Practice Address - Fax:305-294-2197
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME148502207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113854100Medicaid
6659827Medicare UPIN