Provider Demographics
NPI:1881642650
Name:CHECKVER, MITCHELL DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:DAVID
Last Name:CHECKVER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7211 N DALE MABRY HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2669
Mailing Address - Country:US
Mailing Address - Phone:813-933-2841
Mailing Address - Fax:813-915-0326
Practice Address - Street 1:7211 N DALE MABRY HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2669
Practice Address - Country:US
Practice Address - Phone:813-933-2841
Practice Address - Fax:813-915-0326
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS0004309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
592962653OtherTAX ID
E32282Medicare UPIN
82643Medicare ID - Type Unspecified