Individual
MS. DONNA JO SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10475 CENTURION PKWY N, SUITE 303, JACKSONVILLE, FL 32256-5003
(904) 399-0350
(904) 399-5914
Mailing address
11945 SAN JOSE BLVD 300, JACKSONVILLE, FL 32223-1627
(904) 396-1725
(904) 399-1717
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA3168
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003133338A
—
GA
05
—
008639600
—
FL
01
—
970010579
RAILROAD MEDICARE
FL
Enumeration date
11/08/2005
Last updated
11/18/2015
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