Smith, Clement Gustavous

Smith, Clement Gustavous is an sole proprietor health care provider with primary practice located at 3081 Jody Street , Port Charlotte FL 33948. He recently has only one registered license in Nursing Service Related Providers / Adult Companion, which is considered as his primary health care specialty. Smith, Clement Gustavous can be contacted via phone (941) 764-7461.

Contact Information

Primary practice address
3081 Jody Street Port Charlotte FL 33948
Fax: (941) 764-7461
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Adult Companion 372600000X

Profile Details

NPI number 1023362373
LBN Legal business name Smith, Clement Gustavous
Credentials CAREGIVER
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2012
Last updated Nov 7th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023362373 NPPES
Florida MEDICAID 000957800

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