Provider Demographics
NPI:1437268000
Name:SMITH, PETER LLOYD II (MS PT)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:LLOYD
Last Name:SMITH
Suffix:II
Gender:M
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 SW 195TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6208
Mailing Address - Country:US
Mailing Address - Phone:954-436-7046
Mailing Address - Fax:
Practice Address - Street 1:3325 HOLLYWOOD BLVD STE 200
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6926
Practice Address - Country:US
Practice Address - Phone:954-986-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT19471OtherLICENSE #