Provider Demographics
NPI:1093085391
Name:SMITH, DONALD E (HIS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:SMITH
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-4600
Mailing Address - Country:US
Mailing Address - Phone:352-751-6400
Mailing Address - Fax:352-787-4323
Practice Address - Street 1:541 FIELDCREST DR
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-4600
Practice Address - Country:US
Practice Address - Phone:352-751-6400
Practice Address - Fax:352-787-4323
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4476237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist