Charles Lester Talan Mitchell, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT29295 Issued in FL

Practice address

520 Palm Coast Pkwy SW
St # 101
Palm Coast, FL 32137-4742

Phone

(386) 446-4107

Fax

(386) 447-2161

NPI assigned

Sep 3, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1316347891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 DONDANVILLE RD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320806405",
            "telephone_number": "901-581-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 PALM COAST PKWY SW",
            "address_2": "ST # 101",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374742",
            "telephone_number": "386-446-4107",
            "fax_number": "386-447-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CHARLES",
        "middle_name": "LESTER TALAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT29295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonia Isabel Millan Pinzon, MD
• Katherine Faye Miller, B.A., M.S.
• Lucia Miller
• Zachary Miller, LMHC, MCAP
• Yohanna Mills
• Nicole Mitchell
• Tamara Michelle Mitchell, LPN
• MJ Investment Enterprises, LLC
• Mlacson Rnfa Services Inc.
• Patricia Isabel Modad, M.D., F.A.C.O.G.

• Physical Therapist in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.