Individual
MRS. VICTOR NORDINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8787 SALT GRASS DR, PENSACOLA, FL 32526-3262
(850) 503-6090
Mailing address
8787 SALT GRASS DR, PENSACOLA, FL 32526-3262
(850) 503-6090
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690437896
—
FL
05
—
690447898
—
FL
Enumeration date
10/16/2007
Last updated
04/19/2016
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