Provider Demographics
NPI:1477926962
Name:MITCHELL, BERNICE (RBT)
Entity type:Individual
Prefix:
First Name:BERNICE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 PETERS RD STE 1000
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3266
Mailing Address - Country:US
Mailing Address - Phone:954-916-2618
Mailing Address - Fax:954-916-2601
Practice Address - Street 1:8201 PETERS RD STE 1000
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3266
Practice Address - Country:US
Practice Address - Phone:954-916-2618
Practice Address - Fax:954-916-2601
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other