Healthcare Provider Details

I. General information

NPI: 1811892094
Provider Name (Legal Business Name): VENTASIA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR
MIAMI FL
33176-2144
US

IV. Provider business mailing address

27415 SW 143RD CT
HOMESTEAD FL
33032-8875
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-5959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number11043175
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: