Individual
ANGELA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
6745 N CHURCH AVE, MULBERRY, FL 33860-2080
(863) 701-2573
(863) 701-2595
Mailing address
6810 GLENBROOK DR, LAKELAND, FL 33811-2390
(863) 797-5066
(863) 701-2595
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO3518
FL
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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