Provider Demographics
NPI:1396719506
Name:SMITH, NORAH MARIA (MD)
Entity type:Individual
Prefix:
First Name:NORAH
Middle Name:MARIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:863-293-2144
Mailing Address - Fax:863-293-3732
Practice Address - Street 1:550 POPE AVE NW # 100
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4679
Practice Address - Country:US
Practice Address - Phone:863-293-2144
Practice Address - Fax:863-293-3732
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2021-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME81199208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01309647OtherAMERIGROUP
FL260285700Medicaid
FL524974OtherWELLCARE
FL51662OtherBLUE CROSS BLUE SHIELD