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General NPI Number Information
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NPI Number | 1699809012
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Entity Type | Individual
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Provider Name | DINA M. SMITH P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 2993 CHICA CIR
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-6805
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Country | US
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Telephone | 321-759-8380
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Fax | 321-733-0928
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Provider Business Mailing Address
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Address Line | 2993 CHICA CIR
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-6805
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Country | US
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Telephone | 321-759-8380
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Fax | 321-733-0928
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT 13583
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT 13583
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | PT13583
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License Number State | FL
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