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1194135079
BRIAN SMITH
WINTER GARDEN, FL
NPI
1194135079
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
314000000X Skilled Nursing Facility
(Licence: FL PTA23307)
Enumeration Date
2014-05-01
Last Update Date
2014-05-01
Business Address
Mr. BRIAN SMITH PTA
15204 W COLONIAL DR
WINTER GARDEN, FL 34787-6042
Phone number: 407-877-2394
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Mailing Address
Mr. BRIAN SMITH PTA
5247 COUNTY ROAD 561
CLERMONT, FL 34714-8808
Phone number:
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