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Individual

MR. BRENT SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
919 E 2ND ST, SANFORD, FL 32771-2101
(407) 323-2036
Mailing address
5151 ADANSON ST, ORLANDO, FL 32804-1317

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH20433
FL
251C00000X
Developmentally Disabled Services Day Training Agency
1164581633
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
116458163
SEMINOLE MENTAL HEALTH
FL
Enumeration date
05/15/2007
Last updated
12/11/2023
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