Provider Demographics
NPI:1700339520
Name:SMITH, RHONDA (DO)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2533 WINDGUARD CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7348
Mailing Address - Country:US
Mailing Address - Phone:813-991-6060
Mailing Address - Fax:
Practice Address - Street 1:2533 WINDGUARD CIR STE 102
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7348
Practice Address - Country:US
Practice Address - Phone:813-991-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4268156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist