Provider Demographics
NPI:1952163685
Name:MITCHELL, EUGENE RACHI
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:RACHI
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15670 SW 46TH AVENUE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-3174
Mailing Address - Country:US
Mailing Address - Phone:917-553-2805
Mailing Address - Fax:
Practice Address - Street 1:15670 SW 46TH AVENUE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-3174
Practice Address - Country:US
Practice Address - Phone:917-553-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL37AHCH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)