Individual
CAROLINE O SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1670 ST VINCENTS WAY, MIDDLEBURG, FL 32068-8447
(904) 602-1400
Mailing address
96 E TEAGUE BAY DR, ST AUGUSTINE, FL 32092-3093
(203) 572-2439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002022
CT
363A00000X
Physician Assistant
Primary
PA9106283
FL
Other
Enumeration date
12/13/2007
Last updated
11/18/2015
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