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NPI Code Detail

MEDICARE: DEVIN MARIE SMITH

MEDICARE: DEVIN MARIE SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2104100000XSocial WorkerSW22969FL

General Provider Information

NPI Number : 1164980868
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVIN MARIE SMITH
Provider Business Mailing Address
First Line : 7821 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-3275
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7821 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-3275
Country : US
Telephone Number : 727-288-7573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2019
Last Update Date : 08/07/2024

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