Individual
MR. TRACY L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
917 S DR MLK JR BLVD, DAYTONA BEACH, FL 32114-6062
(386) 295-1071
Mailing address
917 S DR MLK JR BLVD, DAYTONA BEACH, FL 32114-6062
(386) 295-1071
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND5954
FL
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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