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General NPI Number Information
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NPI Number | 1811719339
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Entity Type | Individual
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Provider Name | IRVING HADDEN SMITH III III RRT
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Gender | Male
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 71 S DIXIE HWY STE 4
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-4174
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Country | US
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Telephone | 904-825-0022
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Fax | 904-508-0536
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Provider Business Mailing Address
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Address Line | 408 PHEASANT RD
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City | SATSUMA
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State | FL
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Zip | 32189-2338
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Country | US
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Telephone | 386-916-9106
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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 | 2279G1100X
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Taxonomy Name | General Care Registered Respiratory Therapist
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License Number | RT21336
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | RT21336
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License Number State | FL
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