Individual
MR. BROCK LEWIS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3251 N MCMULLEN BOOTH RD STE 301, CLEARWATER, FL 33761-2022
(727) 669-5300
(727) 669-5366
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 315-7469
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9117281
FL
363AS0400X
Surgical Physician Assistant
PA02632
TX
Other
Enumeration date
10/11/2005
Last updated
08/04/2023
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