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General NPI Number Information
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NPI Number | 1760161228
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Entity Type | Individual
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Provider Name | ALEXANDER SMITH
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Gender | Male
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 12794 FOREST HILL BLVD STE 9-10
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City | WELLINGTON
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State | FL
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Zip | 33414-4710
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Country | US
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Telephone | 561-660-1134
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Fax |
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Provider Business Mailing Address
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Address Line | 1891 W 13TH ST
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-6411
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Country | US
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Telephone | 561-660-1134
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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