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General NPI Number Information
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NPI Number | 1295149250
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Entity Type | Organization
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Legal Business Name | SMH PHYSICIAN SERVICES INC
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 997 US HIGHWAY 41 BYP N SUITE 202
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City | VENICE
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State | FL
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Zip | 34285-6046
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Country | US
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Telephone | 941-917-2600
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Fax | 941-917-7884
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Provider Business Mailing Address
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Address Line | PO BOX 863407
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City | ORLANDO
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State | FL
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Zip | 32886-3407
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Country | US
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Telephone | 941-917-2600
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Fax | 941-917-7884
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Authorized Official
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Title or Position | COO
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Name | ILENE GILBERT
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Credential | COO
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Telephone | 941-917-8720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME111784
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME84613
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License Number State | FL
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