Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | OS14048 | FL |
NPI | 1043584485 |
---|---|
Provider Name | Mr. Joshua Daniel Smith |
First Address | Sarasota, FL 34239-2932 |
Second Address | Joplin, MO 64804-3503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2012 |
Last Update Date | 02/04/2021 |