Healthcare Provider Details
I. General information
NPI: 1144427253
Provider Name (Legal Business Name): SMITH WINQUIST & ASSOCIATES MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2007
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2631 MCCORMICK DR STE 101
CLEARWATER FL
33759-1075
US
IV. Provider business mailing address
2631 MCCORMICK DR STE 101
CLEARWATER FL
33759-1075
US
V. Phone/Fax
- Phone: 727-842-4848
- Fax: 727-842-9513
- Phone: 727-842-4848
- Fax: 727-842-9513
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NICHOLAS
LANCIA
Title or Position: PRESIDENT
Credential: MD
Phone: 727-842-4848