Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | ME64048 | FL |
NPI | 1487694311 |
---|---|
Provider Name | Dr. Suzanne Skoda Smith |
First Address | Gainesville, FL 32610-0371 |
Second Address | Gainesville, FL 32610-0371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F57020 | (02) |