Individual
MR. RANDY ROY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3100 NW 39TH ST, LAUDERDALE LAKES, FL 33309-4918
(954) 513-8184
Mailing address
3100 NW 39TH ST, LAUDERDALE LAKES, FL 33309-4918
(954) 513-8184
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02807
MD
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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