Provider Demographics
NPI:1700886538
Name:SMITH, PARINITA SHANTA (PT)
Entity Type:Individual
Prefix:
First Name:PARINITA
Middle Name:SHANTA
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 1:3670 HENDERSON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4515
Mailing Address - Country:US
Mailing Address - Phone:813-877-6664
Mailing Address - Fax:813-877-8799
Practice Address - Street 1:3670 HENDERSON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4515
Practice Address - Country:US
Practice Address - Phone:813-258-8020
Practice Address - Fax:813-877-8799
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist