Provider Demographics
NPI:1255330627
Name:SMITH, VALERIE ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BELCHER RD S
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3321
Mailing Address - Country:US
Mailing Address - Phone:727-530-7585
Mailing Address - Fax:727-536-1831
Practice Address - Street 1:1000 BELCHER RD S
Practice Address - Street 2:SUITE 4
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3321
Practice Address - Country:US
Practice Address - Phone:727-530-7585
Practice Address - Fax:727-536-1831
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2810213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU61717Medicare UPIN
FL65639Medicare ID - Type Unspecified