Healthcare Provider Details

I. General information

NPI: 1871005116
Provider Name (Legal Business Name): SMH PHYSICIAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 10/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 ARLINGTON ST STE 310
SARASOTA FL
34239-3513
US

IV. Provider business mailing address

PO BPX 863407
ORLANDO FL
32886-3407
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-6300
  • Fax: 941-917-6306
Mailing address:
  • Phone: 941-917-2600
  • Fax: 941-917-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE A SHIREY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 941-917-8720