Provider Demographics
NPI:1619859691
Name:MITRANI, JESSE (CP)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:MITRANI
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:JESSE
Other - Middle Name:
Other - Last Name:MITRANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CP
Mailing Address - Street 1:6030 HOLLYWOOD BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7923
Mailing Address - Country:US
Mailing Address - Phone:954-981-4800
Mailing Address - Fax:954-981-5222
Practice Address - Street 1:6030 HOLLYWOOD BLVD STE 120
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-7923
Practice Address - Country:US
Practice Address - Phone:954-981-5222
Practice Address - Fax:954-981-5222
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist