Healthcare Provider Details

I. General information

NPI: 1275510430
Provider Name (Legal Business Name): MICHELE SCHWEBEL SMITH PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SAN PABLO RD S EMAIL: SMITH.MICHELE@MAYO.EDU
JACKSONVILLE FL
32224-1865
US

IV. Provider business mailing address

1196 STONEHEDGE TRAIL LN EMIAL: SMITH.MICHELE@MAYO.EDU
ST AUGUSTINE FL
32092-1058
US

V. Phone/Fax

Practice location:
  • Phone: 904-953-2204
  • Fax: 904-953-2274
Mailing address:
  • Phone: 904-808-9905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS33653
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: