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Individual

MR. RENDELL LEE SMITH III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RDN

Contact information

Practice address
502 E MAIN ST, LAKELAND, FL 33801-5014
(334) 538-4130
Mailing address
4263 AUDUBON OAKS CIR APT 203, LAKELAND, FL 33809-5937
(334) 538-4130

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
9862
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86152420
COMMISSION ON DIETETIC REGISTRATION
FL
01
9862
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
11/24/2020
Last updated
11/24/2020
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