Individual
MR. MICHAEL S SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4161 TAMIAMI TRL STE 704, PORT CHARLOTTE, FL 33952-9283
(941) 423-5600
Mailing address
4161 TAMIAMI TRL STE 704, PORT CHARLOTTE, FL 33952-9283
(941) 423-5600
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
20-4308734
FL
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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