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Mitch C Tuttle

Radiology

Allopathic & Osteopathic Physicians

3625 University Blvd S, Jacksonville, FL 32216-4207

PECOS Enrollment

This provider is enrolled in PECOS as MITCH TUTTLE.

Based on the most recent information from CMS, provider Mitch C Tuttle is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1710395314
Provider Type
Individual
Full Name
Tuttle, Mitch C
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
7/27/2014
Last Updated
9/26/2025

Contact Information

Practice Location

3625 University Blvd S, Jacksonville, FL 32216-4207

(904) 702-6111

Unlisted Fax

Mailing Location

5767 W Century Blvd, Los Angeles, CA 90045-5631

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License ME141405 Florida
Code 2085R0202X	Description Radiology Allopathic & Osteopathic Physicians	License 2014014264 Missouri
Code 2085R0202X	Description Radiology Allopathic & Osteopathic Physicians	License 0101278607 Virginia
Code 2085R0202X	Description Radiology Allopathic & Osteopathic Physicians	License A154101 California

Mitch C Tuttle

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Mckenzie, John D

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