MEDICARE: SMH PHYSICIAN SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician
2	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33181	OTHER	FL	BCBS FLORIDA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134434418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMH PHYSICIAN SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 863407
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32886-3407
Country	:	US
Telephone Number	:	941-917-2600
Fax Number	:	941-917-7884

Provider Business Practice Location Address
First Line	:	2345 BOBCAT VILLAGE CENTER RD
Second Line	:	SUITE 202
City	:	NORTH PORT
State	:	FL
Zip	:	34288-8999
Country	:	US
Telephone Number	:	941-257-2930
Fax Number	:	941-257-2923

Authorized Official
Title or Position	:	COO
Name	:	MISS ILENE GILBERT
Credential	:
Telephone Number	:	941-917-8720

Provider Enumeration Date	:	08/11/2010
Last Update Date	:	04/30/2014

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Directions to “SMH PHYSICIAN SERVICES INC ” Practice Location

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