Individual
DR. KEVIN L. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
13621 N FLORIDA AVE, TAMPA, FL 33613-3216
(813) 803-4515
(813) 803-4513
Mailing address
13621 N FLORIDA AVE, TAMPA, FL 33613-3216
(813) 207-8984
(813) 207-8954
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3456
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC3456
FL
332H00000X
Eyewear Supplier
OPC3456
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11221087
CAQH
FL
01
—
582528891
IRS
FL
05
—
620814201
—
FL
01
—
AJ611
GROUP MEDICARE PTAN
FL
Enumeration date
01/04/2006
Last updated
03/19/2026
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