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Individual

MS. DINA M. SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
2993 CHICA CIR, WEST MELBOURNE, FL 32904-6805
(321) 759-8380
(321) 733-0928
Mailing address
2993 CHICA CIR, WEST MELBOURNE, FL 32904-6805
(321) 759-8380
(321) 733-0928

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
PT13583
FL
2251P0200X
Pediatric Physical Therapist
PT 13583
FL
2251X0800X
Orthopedic Physical Therapist
PT 13583
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2110946
FIRST HEALTH
FL
01
5470501
FIRST HEALTH
FL
05
811612100
FL
05
886247800
FL
01
Y9767
BLUE CROSS AND BLUE SHIEL
FL
Enumeration date
03/15/2007
Last updated
06/05/2008
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