Provider Demographics
NPI:1316387731
Name:SMITH, HINA (MD)
Entity Type:Individual
Prefix:DR
First Name:HINA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4542
Mailing Address - Country:US
Mailing Address - Phone:850-763-0017
Mailing Address - Fax:850-692-5862
Practice Address - Street 1:1940 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4542
Practice Address - Country:US
Practice Address - Phone:850-763-0017
Practice Address - Fax:850-692-5862
Is Sole Proprietor?:No
Enumeration Date:2013-06-29
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS256662084P0804X
NV182062084P0804X
FLME1293732084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03806761Medicaid
NV1316387731Medicaid