Individual
DONNA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
8563 ARGYLE BUSINESS LOOP, SUITE 2, JACKSONVILLE, FL 32244-6668
(904) 375-0830
(877) 811-4031
Mailing address
4635 RAGGEDY POINT RD, FLEMING ISLAND, FL 32003-7843
(904) 269-3050
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
OTA11958
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA11958
FLORIDA DEPT. OF HEALTH
FL
Enumeration date
11/08/2011
Last updated
11/08/2011
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