Provider Demographics
NPI:1205011566
Name:HARVEY, HEATHER SMITH (PT PHYSICAL THERAPIS)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:SMITH
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PT PHYSICAL THERAPIS
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MAYNNE
Other - Last Name:KEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HEATHER M SMITH
Mailing Address - Street 1:320 SPANISH MAIN DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERLAND KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-4303
Mailing Address - Country:US
Mailing Address - Phone:239-839-9842
Mailing Address - Fax:865-500-3729
Practice Address - Street 1:1010 KENNEDY DR STE 407
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4134
Practice Address - Country:US
Practice Address - Phone:305-709-1132
Practice Address - Fax:865-500-3729
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT68882251X0800X
FLPT223892251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY05P0OtherFLORIDA BLUE