Provider Demographics
NPI:1285953307
Name:SMH PHYSICIAN SERVICES INC
Entity type:Organization
Organization Name:SMH PHYSICIAN SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-917-8720
Mailing Address - Street 1:1991 MAIN ST
Mailing Address - Street 2:SUITE 245
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-5960
Mailing Address - Country:US
Mailing Address - Phone:941-917-8720
Mailing Address - Fax:941-917-1875
Practice Address - Street 1:5880 RAND BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5118
Practice Address - Country:US
Practice Address - Phone:941-917-5914
Practice Address - Fax:941-917-5912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376537700Medicaid
FL376537700Medicaid