Individual
MS. SHANNON ALEXANDRIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
20621 NE 1ST CT, MIAMI, FL 33179-1702
(305) 807-8622
Mailing address
20621 NE 1ST CT, MIAMI, FL 33179-1702
(305) 807-8622
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND7999
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ND7999
LICENSE NUMBER
FL
Enumeration date
09/12/2020
Last updated
09/12/2020
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