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General NPI Number Information
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NPI Number | 1346977303
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Entity Type | Individual
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Provider Name | CHELSA REGAIL SMITH PT
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Gender | Female
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 11286 BOYETTE RD STE 101
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City | RIVERVIEW
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State | FL
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Zip | 33569-8022
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Country | US
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Telephone | 813-978-9700
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Fax | 813-558-6185
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Provider Business Mailing Address
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Address Line | 13020 N TELECOM PARKWAY
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City | TEMPLE TERRRACE
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State | FL
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Zip | 33637-6326
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Country | US
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Telephone | 813-978-9700
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Fax | 813-558-6185
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT22523
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License Number State | FL
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