Provider Demographics
NPI:1295969830
Name:MITCHELL, JOSHUA R (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:R
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 N ARMENIA AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6438
Mailing Address - Country:US
Mailing Address - Phone:813-262-1330
Mailing Address - Fax:
Practice Address - Street 1:4200 N ARMENIA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6438
Practice Address - Country:US
Practice Address - Phone:813-262-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 121881207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology