MEDICARE: HARRIS SMITH ENTERPRISES 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	174400000X	Specialist	AS3186	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447422803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS SMITH ENTERPRISES INC

Provider Business Mailing Address
First Line	:	4025 20TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-2403
Country	:	US
Telephone Number	:	772-569-0444
Fax Number	:	772-569-7266

Provider Business Practice Location Address
First Line	:	4025 20TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-2403
Country	:	US
Telephone Number	:	772-569-0444
Fax Number	:	772-569-7266

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WILLIAM F SMITH
Credential	:	BC-HIS
Telephone Number	:	772-569-0444

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	12/31/2008

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