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General NPI Number Information
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NPI Number | 1194767319
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Entity Type | Individual
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Provider Name | DAVID ALAN SMITH CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 800 PRUDENTIAL DR
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8202
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Country | US
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Telephone | 904-202-3066
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Fax |
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Provider Business Mailing Address
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Address Line | 4295 HEATH RD
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City | JACKSONVILLE
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State | FL
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Zip | 32277-1587
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Country | US
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Telephone | 904-762-1913
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP2842212
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License Number State | FL
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