Petusevsky, Mitchell Lee
Petusevsky, Mitchell Lee is an individual health care provider with primary practice located at 700 2Nd Ave N Suite 305, Naples FL 34102-5756. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Petusevsky, Mitchell Lee can be contacted via phone (239) 263-8385.Contact Information
Primary practice address
700 2Nd Ave N Suite 305
Naples FL 34102-5756
Phone: (239) 263-8385
Fax: (239) 263-8592
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | FLME0042752 | Florida |
Profile Details
| NPI number | 1275584435 |
|---|---|
| LBN Legal business name | Petusevsky, Mitchell Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 13th, 2006 |
| Last updated | Mar 3rd, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275584435 | NPPES |
| Florida | MEDICAID | 064860400 |
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