Jacqueline Mitchell

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA31538 Issued in FL

Practice address

1701 Park Ave
Orange Park, FL 32073-4946

Phone

(904) 278-1200

Fax

(352) 382-1146

NPI assigned

Nov 19, 2021

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1841957255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8477 S SUNCOAST BLVD",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344465028",
            "telephone_number": "800-804-9961",
            "fax_number": "352-384-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 PARK AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734946",
            "telephone_number": "904-278-1200",
            "fax_number": "352-382-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA31538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Milne, PSY.D.
• Karen L Miner, PA-C
• Kelli Minor, BCBA
• Miracle Ear
• Donte' Kilano Mitchell
• Tiffany Mitchell
• Mitchells All at Home Quality Care Provider Inc
• Dena Rachel Mizrahi, DMD
• MNS Non Emergency Medical Transportation LLC
• Andreea Mocanu, OD

• Physical Therapy Assistant in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.