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Individual
DR. KELLY A SMITH
Active
Individual
DR. KELLY A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC 4065
FL
152W00000X
Optometrist
Primary
OPC4065
FL
152W00000X
Optometrist
S-B14-TA-705
AL
152WC0802X
Corneal and Contact Management Optometrist
OPC 4065
FL
152WC0802X
Corneal and Contact Management Optometrist
S-B14-TA-705
AL
152WP0200X
Pediatric Optometrist
OPC 4065
FL
152WP0200X
Pediatric Optometrist
S-B14-TA-705
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240878
—
AL
01
—
28556
BLUE CROSS & BLUE SHIELD
FL
05
—
621068600
—
FL
01
—
P0030826
RR MEDICARE
FL
Enumeration date
07/12/2006
Last updated
04/30/2026
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