Provider Demographics
NPI:1942611652
Name:DOC SMILEY'S URGENT CARE LLC
Entity Type:Organization
Organization Name:DOC SMILEY'S URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:850-231-1919
Mailing Address - Street 1:43 CASSINE WAY
Mailing Address - Street 2:UNIT 102
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-0456
Mailing Address - Country:US
Mailing Address - Phone:850-231-1919
Mailing Address - Fax:
Practice Address - Street 1:43 CASSINE WAY
Practice Address - Street 2:UNIT 102
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-0456
Practice Address - Country:US
Practice Address - Phone:850-231-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12341261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care