Individual
BERTHA E SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
569 BANKS RD, MARGATE, FL 33063-4602
(954) 258-7060
(954) 978-1960
Mailing address
569 BANKS RD, MARGATE, FL 33063-4602
(954) 258-7060
(954) 978-1960
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED FOR
—
FL
Enumeration date
04/17/2009
Last updated
04/17/2009
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