Healthcare Provider Details

I. General information

NPI: 1730011297
Provider Name (Legal Business Name): NOAH LEE SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FSU COLLEGE OF MEDICINE SCHOOL OF PA PRACTICE 1115 WEST CALL STREET
TALLAHASSEE FL
32306-4300
US

IV. Provider business mailing address

FSU COLLEGE OF MEDICINE SCHOOL OF PA PRACTICE 1115 WEST CALL STREET
TALLAHASSEE FL
32306-4300
US

V. Phone/Fax

Practice location:
  • Phone: 850-644-5323
  • Fax: 850-645-2846
Mailing address:
  • Phone: 850-644-5323
  • Fax: 850-645-2846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: