Healthcare Provider Details

I. General information

NPI: 1780758524
Provider Name (Legal Business Name): ENRIQUE VICTOR SMITH-FORBES OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 10/09/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRNMMC, 8901 ROCKVILLE PIKE
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-5600
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4866
  • Fax:
Mailing address:
  • Phone: 301-295-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number109386
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number109386
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: