Individual
BRIDGETTE CARSON-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2307 AVIENDA AVE, FORT PIERCE, FL 34946-1144
(772) 332-0749
Mailing address
2307 AVIENDA AVE, FORT PIERCE, FL 34946-1144
(772) 332-0749
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
687911096
—
FL
Enumeration date
01/26/2022
Last updated
01/26/2022
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