Individual
BLAINE DANIEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 PALM AVE STE 600, JACKSONVILLE, FL 32207-8457
(904) 202-7300
(904) 202-2754
Mailing address
PO BOX 746654, ATLANTA, GA 30374-6654
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
2022-01059
NC
207Y00000X
Otolaryngology Physician
Primary
ME161800
FL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
ME161800
FL
Other
Enumeration date
04/13/2017
Last updated
05/06/2025
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