Provider Demographics
NPI:1588020366
Name:SMITH, VALERIE PLANTE (PT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:PLANTE
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 1:12901 BROLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6107
Mailing Address - Country:US
Mailing Address - Phone:407-641-0808
Mailing Address - Fax:407-812-4358
Practice Address - Street 1:12901 BROLEMAN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6107
Practice Address - Country:US
Practice Address - Phone:407-641-0808
Practice Address - Fax:407-812-4358
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 31059222Q00000X, 225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist