Smith, Larry Lee
Smith, Larry Lee is an sole proprietor health care provider with primary practice located at 100 W New Haven Ave , Melbourne FL 32901-4303. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Smith, Larry Lee can be contacted via phone (321) 327-7014.Contact Information
Primary practice address
100 W New Haven Ave
Melbourne FL 32901-4303
Phone: (321) 327-7014
Fax: (321) 821-1924
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CH7178 | Florida |
Profile Details
| NPI number | 1922001502 |
|---|---|
| LBN Legal business name | Smith, Larry Lee |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 27th, 2005 |
| Last updated | Sep 9th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922001502 | NPPES |
| Florida | Other | 5804715 | GHI |
| Florida | Other | P1659960 | GHI |
| Florida | Other | 55485 | GHI |
| Florida | Other | 665421 | GHI |
| Florida | MEDICAID | 381082800 | GHI |
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