Provider Demographics
NPI:1346437951
Name:SMITH, CATHERINE JUDITH (PT)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:JUDITH
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-4818
Mailing Address - Country:US
Mailing Address - Phone:727-791-1965
Mailing Address - Fax:727-791-1965
Practice Address - Street 1:3890 TAMPA RD
Practice Address - Street 2:SUITE 308
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3676
Practice Address - Country:US
Practice Address - Phone:727-789-0891
Practice Address - Fax:727-789-1570
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP.T.3077225100000X
FLMA34337225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist