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NPI Code Detail

MEDICARE: SMH PHYSICIAN SERVICES, INC

MEDICARE: SMH PHYSICIAN SERVICES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
233181OTHERFLBCBS OF FL

General Provider Information

NPI Number : 1699209270
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMH PHYSICIAN SERVICES, INC
Provider Business Mailing Address
First Line : PO BOX 863407
Second Line :
City : ORLANDO
State : FL
Zip : 32886-3407
Country : US
Telephone Number : 941-917-2600
Fax Number : 941-917-7884
Provider Business Practice Location Address
First Line : 1825 DR MARTIN LUTHER KING WAY
Second Line :
City : SARASOTA
State : FL
Zip : 34234-2525
Country : US
Telephone Number : 941-952-4123
Fax Number : 941-952-4101
Authorized Official
Title or Position : FPG ADMINISTRATOR
Name : MICHELLE A SHIREY
Credential :
Telephone Number : 941-917-8720
Provider Enumeration Date : 04/20/2017
Last Update Date : 04/20/2017

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Directions to “SMH PHYSICIAN SERVICES, INC ” Practice Location

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