Healthcare Provider Details

I. General information

NPI: 1417872847
Provider Name (Legal Business Name): BROOKE SMITH DR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 MAGUIRE RD STE 1009
OCOEE FL
34761-4742
US

IV. Provider business mailing address

2910 MAGUIRE RD STE 1009
OCOEE FL
34761-4742
US

V. Phone/Fax

Practice location:
  • Phone: 407-877-8707
  • Fax: 407-877-7464
Mailing address:
  • Phone: 407-877-8707
  • Fax: 407-877-7464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16081
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: