MEDICARE: PLEASANT SMITH EMERGENCY PHYSICIANS, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner
3	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1417396391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT SMITH EMERGENCY PHYSICIANS, PLLC

Provider Business Mailing Address
First Line	:	18167 US HIGHWAY 19 N
Second Line	:	STE. 650
City	:	CLEARWATER
State	:	FL
Zip	:	33764-3528
Country	:	US
Telephone Number	:	727-507-2519
Fax Number	:	727-536-2896

Provider Business Practice Location Address
First Line	:	9711 N SAM HOUSTON PKWY E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-4482
Country	:	US
Telephone Number	:	727-507-2519
Fax Number	:	727-536-2896

Authorized Official
Title or Position	:	PRES, TX-I MEDICAL SERVICES, PA
Name	:	DR. GREGORY J BYRNE
Credential	:	MD
Telephone Number	:	800-507-8874

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	06/24/2013

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