Provider Demographics
NPI:1962590547
Name:SMITH, HOWARD (PHARMD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9933 CAROLINE PARK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5858
Mailing Address - Country:US
Mailing Address - Phone:407-892-5232
Mailing Address - Fax:407-892-5076
Practice Address - Street 1:4855 EAST IRLO BRONSON HWY
Practice Address - Street 2:
Practice Address - City:ST. CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771
Practice Address - Country:US
Practice Address - Phone:407-892-5232
Practice Address - Fax:407-892-5076
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0029263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS0029263OtherPHARMACIST LICENSE