National Provider Identifier Database

EDWARD MITCHELL JR, LDO – NPI #1811139462
Eyewear Supplier

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.


Contact Information

EDWARD MITCHELL JR, LDO
4100 S FERDON BLVD STE B5
CRESTVIEW, FL32536-5287
Phone: 850-758-0474
Fax: 850-682-0057
Website:
Specialty Taxonomy Code
* Eyewear Supplier 332H00000X
Contact Lens Fitter 156FC0801X
Optician 156FX1800X

* Indicates primary specialty

NPI Profile & details for EDWARD MITCHELL JR

NPI Number 1811139462
Credentials LDO
Entity Individual
Enumeration date 03/28/2009
Last updated 10/15/2019 - About 7 years ago
Sole proprietor1 Yes
Identifiers
  • FL License #: 5539
  • FL License #: DO 5539
  • FL License #: DO5539
  • Other: 80-0442282 IRS
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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