Provider Demographics
NPI:1851403968
Name:SMART TECH MEDICAL INC
Entity Type:Organization
Organization Name:SMART TECH MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-887-6153
Mailing Address - Street 1:1700 N DIXIE HWY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1850
Mailing Address - Country:US
Mailing Address - Phone:305-887-6153
Mailing Address - Fax:305-887-7340
Practice Address - Street 1:1700 N DIXIE HWY
Practice Address - Street 2:SUITE 115
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1850
Practice Address - Country:US
Practice Address - Phone:305-887-6153
Practice Address - Fax:305-887-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE2612Medicare ID - Type UnspecifiedIDTF