# SMH PHYSICIAN SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Harbour Time Share Office
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730593773
- **Authorized official:** ILENE GILBERT-DROGE COO (COO)
- **Authorized official phone:** (941) 917-8700

## Contact information

- **Practice address:** 1040 RIVER HERITAGE BLVD, SUITE 202, BRADENTON, FL 34212-6348
- **Practice address phone:** (941) 917-2600
- **Practice address fax:** (941) 917-7884
- **Mailing address:** PO BOX 863407, ORLANDO, FL 32886-3407
- **Mailing address phone:** (941) 917-2600
- **Mailing address fax:** (941) 917-7884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | ME111784 | FL | — |
| 207V00000X | Obstetrics & Gynecology Physician | ME84613 | FL | Yes |

## Other

- **Enumeration date:** 06/18/2014
- **Last updated:** 10/13/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 33181 | BCBS | FL |
| 05 | — | 376537700 | — | FL |