MEDICARE: DR. SUZANNE MCGUFFIN SMITH D.C.

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
1	111N00000X	Chiropractor	CH10247	FL

General Provider Information

NPI Number	:	1679866693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE MCGUFFIN SMITH D.C.

Provider Business Mailing Address
First Line	:	1123 3RD ST N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-7240
Country	:	US
Telephone Number	:	904-372-0322
Fax Number	:	904-372-0527

Provider Business Practice Location Address
First Line	:	1123 3RD ST N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250
Country	:	US
Telephone Number	:	904-372-0322
Fax Number	:	904-372-0527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2011
Last Update Date	:	06/08/2018

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