Provider Demographics
NPI:1386742765
Name:SMITH, ORIN ELBERT JR (RPH)
Entity type:Individual
Prefix:MR
First Name:ORIN
Middle Name:ELBERT
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 N. KROME AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030
Mailing Address - Country:US
Mailing Address - Phone:305-247-6949
Mailing Address - Fax:305-247-6072
Practice Address - Street 1:806 N. KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030
Practice Address - Country:US
Practice Address - Phone:305-247-6949
Practice Address - Fax:305-247-6072
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS12506183500000X
FLPU1754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist