Individual
DELIA A. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1264 MALABAR RD SE, PALM BAY, FL 32907-2556
(321) 434-1486
(321) 434-5295
Mailing address
99 PELICAN DR, MELBOURNE BEACH, FL 32951-3736
(601) 421-0091
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME147647
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108675700
—
FL
01
—
550033371
RAILROAD MEDICARE
—
01
—
RU186
HFMG MA
FL
Enumeration date
11/16/2005
Last updated
10/16/2023
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