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General NPI Number Information
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NPI Number | 1609400688
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Entity Type | Individual
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Provider Name | ELLIOT VICTOR SMITHSON DPT, ATC, EMT
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Gender | Male
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Dates
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Enumeration Date | 02/27/2020
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 401 S CAMDEN DR APT 8
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4263
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Country | US
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Telephone | 407-415-3712
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Fax |
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Provider Business Mailing Address
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Address Line | 248 SPRING RUN CIR
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City | LONGWOOD
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State | FL
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Zip | 32779-5029
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Country | US
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Telephone | 407-415-3712
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Fax |
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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 | 298206
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 35555
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 554022
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3532
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License Number State | FL
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