Organization
SMH PHYSICIAN SERVICES INC
Active
Other names
Pain Mgmt at Heritage Harbor
Organization subpart
No
Provider details
NPI number
Authorized official
ILENE GILBERT COO (COO)
(941) 917-8720
Entity
Organization
Contact information
Practice address
1040 RIVER HERITAGE BLVD, SUITE 201, BRADENTON, FL 34212-6348
(941) 917-4500
(941) 917-4507
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME111784
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33181
BCBS
FL
05
—
376537700
—
FL
Enumeration date
06/19/2014
Last updated
06/19/2014
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