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Individual
MARK ROBERT SMITH
Active
Individual
MARK ROBERT SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23938
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT23938
STATE OF FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
03/30/2017
Last updated
03/30/2017
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