Healthcare Provider Details

I. General information

NPI: 1912179656
Provider Name (Legal Business Name): ANA-LILIA SMITH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: A. LILIA SMITH PH.D.

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 05/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 VENERA AVE STE 225
CORAL GABLES FL
33146-3032
US

IV. Provider business mailing address

1501 VENERA AVE STE 225
CORAL GABLES FL
33146-3032
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-6399
  • Fax:
Mailing address:
  • Phone: 305-596-6399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number6608
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6608
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number6608
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number6608
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number6608
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number6608
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number6608
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: