Mitchell, Edward

Mitchell, Edward is an sole proprietor health care provider with primary practice located at 4100 S Ferdon Blvd Ste B5 , Crestview FL 32536-5287. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Contact Lens Fitter, Eye and Vision Services Providers / Optician, Suppliers / Eyewear Supplier (Equipment, not the service). Suppliers / Eyewear Supplier (Equipment, not the service) is his primary health care specialty. Mitchell, Edward can be contacted via phone (850) 758-0474.

Contact Information

Primary practice address
4100 S Ferdon Blvd Ste B5 Crestview FL 32536-5287
Phone: (850) 758-0474
Fax: (850) 682-0057
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Contact Lens Fitter 156FC0801X DO 5539 Florida
Eye and Vision Services Providers / Optician 156FX1800X DO 5539 Florida
Eye and Vision Services Providers / Optician 156FX1800X 5539 Florida
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X DO5539 Florida

Profile Details

NPI number 1811139462
LBN Legal business name Mitchell, Edward
Credentials LDO
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2009
Last updated Oct 15th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811139462 NPPES
Other 80-0442282 IRS

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