MEDICARE: DR. BRIAN ALBERT SMITH D.C.

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	111NI0900X	Internist Chiropractor	DC18647	CA

General Provider Information

NPI Number	:	1285630434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ALBERT SMITH D.C.

Provider Business Mailing Address
First Line	:	12746 PARKBURY DRIVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828
Country	:	US
Telephone Number	:	407-457-2800
Fax Number	:	518-684-8526

Provider Business Practice Location Address
First Line	:	12746 PARKBURY DRIVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828
Country	:	US
Telephone Number	:	407-457-2800
Fax Number	:	518-684-8526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/02/2024

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