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16877 E Colonial Dr Ste 327 Orlando FL 32820-1910 | |
| (858) 876-4539 | |
| (407) 704-1787 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 16877 E Colonial Dr Ste 327, Orlando, Florida |
| Authorized Official Name and Position | David S Smiley (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 8588764539 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
16877 E Colonial Dr Ste 327 Orlando FL 32820-1910 Ph: (858) 876-4539 | 16877 E Colonial Dr Ste 327 Orlando FL 32820-1910 Ph: (858) 876-4539 |
| NPI Number | 1396475562 |
|---|---|
| Provider Enumeration Date | 06/12/2022 |
| Last Update Date | 06/16/2023 |
| Certification Date | 06/16/2023 |
| Medicare PECOS PAC ID | 3375927122 |
|---|---|
| Medicare Enrollment ID | O20220829002496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396475562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | David S Smiley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235404179 PECOS PAC ID: 8022270669 Enrollment ID: I20120427000260 |
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