Provider Demographics
NPI:1841077336
Name:SMILEY DESTINATIONS, LLC
Entity type:Organization
Organization Name:SMILEY DESTINATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-327-8230
Mailing Address - Street 1:11018 GRANDE PINES CIR APT 1214
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-9344
Mailing Address - Country:US
Mailing Address - Phone:334-327-8230
Mailing Address - Fax:
Practice Address - Street 1:37 N ORANGE AVE STE 222
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2439
Practice Address - Country:US
Practice Address - Phone:334-327-8230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)