Individual
JAMES DARRYL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4566 E HIGHWAY 20, NICEVILLE, FL 32578-8838
(850) 897-7546
Mailing address
4416 RANCHWOOD LN, TAMPA, FL 33624-1731
(813) 928-8157
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107749
FL
363AM0700X
Medical Physician Assistant
PA9107749
FL
363AS0400X
Surgical Physician Assistant
PA9107749
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9107749
DEPARTMENT OF HEALTH
FL
Enumeration date
02/12/2014
Last updated
02/12/2014
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