Provider Demographics
NPI:1346585296
Name:SMITH, CHRISTINE F (IBCLC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:F
Last Name:SMITH
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6819 BROKEN ARROW TRL S
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3708
Mailing Address - Country:US
Mailing Address - Phone:863-640-0117
Mailing Address - Fax:
Practice Address - Street 1:6819 BROKEN ARROW TRL S
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3708
Practice Address - Country:US
Practice Address - Phone:863-640-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN