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NPI Code Detail

MEDICARE: JEFF SMITH PTA

MEDICARE: JEFF SMITH PTA
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
1225200000XPhysical Therapy AssistantPTA14287FL

General Provider Information

NPI Number : 1891212692
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFF SMITH PTA
Provider Business Mailing Address
First Line : 1713 S MANHATTAN AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-5619
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 231 COURTYARD BLVD
Second Line :
City : SUN CITY CENTER
State : FL
Zip : 33573-5759
Country : US
Telephone Number : 813-642-7447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2017
Last Update Date : 08/23/2017

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Directions to “ JEFF SMITH PTA” Practice Location

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