Provider Demographics
NPI:1730206889
Name:SMIT, ROBERT J (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:SMIT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 CREEKSIDE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-1948
Mailing Address - Country:US
Mailing Address - Phone:239-254-9798
Mailing Address - Fax:239-596-4501
Practice Address - Street 1:1280 CREEKSIDE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1948
Practice Address - Country:US
Practice Address - Phone:239-254-9798
Practice Address - Fax:239-596-4501
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501001775225100000X
FLPT29400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist