Provider Demographics
NPI:1295079754
Name:MITCHELL, CHERYL (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3089 HILLSIDE LN
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-5319
Mailing Address - Country:US
Mailing Address - Phone:724-747-9313
Mailing Address - Fax:
Practice Address - Street 1:1944 N HERCULES AVE
Practice Address - Street 2:SUITE C
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-4403
Practice Address - Country:US
Practice Address - Phone:727-797-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 021825225100000X
FLPT 27194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist