Individual
DR. NICHOLAS DAVID WOLOSZYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
501 6TH ST S, ST PETERSBURG, FL 33701-4630
(727) 767-7451
Mailing address
2937 WINGLEWOOD CIR, LUTZ, FL 33558-5036
(724) 599-4315
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY11240
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113855800
—
FL
01
—
MYDVF
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/14/2022
Last updated
11/01/2022
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