MR. MATTHEW RYAN SMITH ATC LAT NPI 1144412362

NPI Information

  • NPI: 1144412362
  • Provider Name: MR. MATTHEW RYAN SMITH, ATC, LAT
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 615 VONDERBURG DR
    BRANDON, FL
    ZIP 33511
  • Phone: (813) 684-2663

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NPI Details

MR. Matthew Ryan Smith, ATC, LAT is a medical physician assistant in Brandon, FL. MR. Matthew Ryan Smith, ATC, LAT NPI is 1144412362. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

615 VONDERBURG DR
BRANDON, FL
ZIP 33511-972
Phone: (813) 684-2663
Fax: (813) 685-9178

The NPI 1144412362 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/12/2007 and was last updated on 2/4/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA9107760FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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