Healthcare Provider Details

I. General information

NPI: 1962590547
Provider Name (Legal Business Name): HOWARD SMITH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 EAST IRLO BRONSON HWY
ST. CLOUD FL
34771
US

IV. Provider business mailing address

9933 CAROLINE PARK DR
ORLANDO FL
32832-5858
US

V. Phone/Fax

Practice location:
  • Phone: 407-892-5232
  • Fax: 407-892-5076
Mailing address:
  • Phone: 407-892-5232
  • Fax: 407-892-5076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS0029263
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: