Healthcare Provider Details

I. General information

NPI: 1750344917
Provider Name (Legal Business Name): SMITH WINQUIST & ASSOCIATES MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
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

Practice location:
  • Phone: 727-842-4848
  • Fax: 727-842-9513
Mailing address:
  • Phone: 727-842-4848
  • Fax: 727-842-9513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number10D0717479
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number10D0717479
License Number StateFL

VIII. Authorized Official

Name: DR. NICHOLAS LANCIA
Title or Position: PRESIDENT
Credential: MD
Phone: 727-842-4848