# DR. WANDA IVELISSE SMITH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1972797348
- **Gender:** F
- **Credential:** M.D.; MPH

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 7586 | PR | — |
| 207Q00000X | Family Medicine Physician | ACN897 | FL | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | MPH | PR | — |
| 208D00000X | General Practice Physician | ACN897 | FL | Yes |

## Other

- **Enumeration date:** 08/29/2007
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 020108900 | — | FL |
| 01 | — | 2542 | DIPLOMATE AMERICAN BOARD OF SEXOLOGY | FL |
| 01 | — | ACN 897 | MD LICENSE | FL |
| 01 | — | XX86 | MD LICENSE | PR |