Individual
MICHELLE MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
501 6TH AVE S, DEPT # 6580070302, ST PETERSBURG, FL 33701-4634
(727) 767-4429
Mailing address
601 5TH ST S, DEPARTMENT #6500002705, ST PETERSBURG, FL 33701-4804
(727) 767-3051
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME85415
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264416900
—
FL
Enumeration date
06/26/2006
Last updated
08/20/2016
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