Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. EDWARD MITCHELL JR., LDO
Active Sole ProprietorEyewear Supplier · CRESTVIEW, FL
Registration Details
- NPI Number
- 1811139462
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 28, 2009 (17.070544181524 yrs)
- Last Updated
- Oct 15, 2019
- Licenses
-
DO 5539 (FL)DO 5539 (FL)5539 (FL)DO5539 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4100 S FERDON BLVD STE B5CRESTVIEW, FL, 325365287Browse FL providers · Browse ZIP 32536
- Phone
- 8507580474
- Fax
- 8506820057
- Primary Specialty
-
Eyewear Supplier
332H00000X
- Additional Specialty
- Optician, Dispensing
- Additional Specialty
- Optician, Dispensing
- Additional Specialty
- Eyewear Supplier
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.