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General NPI Number Information
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NPI Number | 1942611652
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Entity Type | Organization
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Legal Business Name | DOC SMILEY'S URGENT CARE LLC
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Dates
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Enumeration Date | 05/15/2014
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 43 CASSINE WAY UNIT 102
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-0456
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Country | US
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Telephone | 850-231-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 43 CASSINE WAY UNIT 102
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-0456
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Country | US
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Telephone | 850-231-1919
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | CHRISTINE SMILEY
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Credential | D.O.
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Telephone | 850-231-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | OS12341
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License Number State | FL
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