DR. WANDA IVELISSE SMITH (NPI# 1972797348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972797348 |
| Entity Type | Individual |
| Full Name | DR. WANDA IVELISSE SMITH |
| Credential | M.D.; MPH |
| Practice Address |
1301 W Colonial Dr Orlando FL 32804-7133 |
| Mailing Address |
4440 Fruitville Rd Sarasota FL 34232-1926 |
| Practice Telephone | 4072461946 |
| Practice Fax Number | 8559855749 |
| Mailing Telephone | 9413660134 |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2020-06-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 7586 | PR | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | ACN897 | FL | Allopathic & Osteopathic Physicians |
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
MPH | PR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | DIPLOMATE AMERICAN BOARD OF SEXOLOGY | 2542 | 01 |
| FL | DEA | FS57XXXXX | 01 |
| PR | DEA BUPRENORPHINE & OPIOS DEPENDENCE TREATMENT | XS57XXXXX | 01 |
| FL | 020108900 | 05 | |
| PR | MD LICENSE | XX86 | 01 |
| FL | MD LICENSE | ACN 897 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225551245 | Wanda Elaine Smith | Counselor | 3007 Knight St. Suite 200, Shreveport, LA 71105 | 2017-07-21 |
| 1346626157 | Wanda Smith | Social Worker | 13005 Marthas Choice Cir, Bowie, MD 20720-4704 | 2015-08-04 |
| 1083045496 | Wanda Elaine Smith | Assisted Living Facility | 1046 E. Lancaster Blvd, Lancaster, CA 93535 | 2013-12-11 |
| 1407193550 | Wanda Denice Smith | Counselor | 2416 Sw Oxford Dr, Lawton, OK 73505-0802 | 2013-01-09 |
| 1841321346 | Wanda G Smith | Dentist | 829 N Jefferson St, Wilmington, DE 19801-1431 | 2007-03-08 |
| 1144392796 | Wanda Renee Smith | Speech-Language Pathologist | 1705 Country Garden Dr, Shelby, NC 28150-6162 | 2006-11-15 |
| 1154813582 | Wanda B Smith | Counselor | 113 W Convent St, Lafayette, LA 70501 | 2018-06-01 |
| 1710488465 | Wanda H Smith | Occupational Therapist | 29200 Schoolcraft Rd, Livonia, MI 48150-2228 | 2018-02-27 |
| 1942755863 | Wanda G Smith | Registered Nurse | 1910 Jackson St, Monroe, LA 71202 | 2016-08-20 |
| 1982918264 | Wanda Faye Smith | Registered Nurse | 126 East Main Street, Newbern, TN 38059 | 2010-07-29 |
| Street Address |
1301 W COLONIAL DR |
| City | ORLANDO |
| State | FL |
| Zip Code | 32804-7133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972141166 | Jtj Medical Supply, Inc. | Pharmacy | 1301 W Colonial Dr, Orlando, FL 32804-7133 | 2019-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881252716 | Alyssa Bass | Counselor | 3130 Edgewater Dr, Orlando, FL 32804 | 2019-06-05 |
| 1841856366 | Debora Cheryl Ramirez | Technician/Technologist | 1231 North Orange Ave, Orlando, FL 32804 | 2019-05-10 |
| 1679074009 | Jessica Dobbs | Counselor | 3801 Grant Blvd, Orlando, FL 32804 | 2018-02-21 |
| 1881109031 | Pedro Mendez Jr. | Counselor | 1800 W. Colonial Drive, Orlando, FL 32804 | 2017-12-11 |
| 1902259310 | Michael Lo | Nurse Practitioner | 2400 N Orange Ave Ste 302, Orlando, FL 32804 | 2016-07-20 |
| 1083093595 | Michael Gregg | Student in an Organized Health Care Education/Training Program | 2415 North Orange Avenue, Suite 400, Orlando, FL 32804 | 2015-05-29 |
| 1922485473 | Lindsay Rae Piet | Physician Assistant | 1910 N. Orange Ave., Orlando, FL 32804 | 2015-05-05 |
| 1093106189 | College Park Community Acupuncture & Herbal Medicine | Acupuncturist | 710 W. Princeton Street., Suite A, Orlando, FL 32804 | 2015-02-10 |
| 1164822359 | Orlando Sleep Solutions, LLC | Durable Medical Equipment & Medical Supplies | 2921 N. Orange Ave, Orlando, FL 32804 | 2014-08-26 |
| 1780926741 | Joseph Arturo Reza | Student in an Organized Health Care Education/Training Program | 2415 N Orange Ave #400, Orlando, FL 32804 | 2013-03-17 |
| Find all providers in zip 32804 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609484336 | Rw Family Practice & Preventive Care, LLC. | Family Medicine | 6735 Conroy Rd Ste 418, Orlando, FL 32835-3566 | 2020-07-20 |
| 1750906855 | Ashleigh Kittel | Family Medicine | 646 W Smith St Unit 506, Orlando, FL 32804-5383 | 2020-06-15 |
| 1962031633 | Annuel Lebrun | Family Medicine | 5317 Curry Ford Rd Apt K202, Orlando, FL 32812-7209 | 2020-04-05 |
| 1427699610 | Orlando Wellness | Family Medicine | 2909 N Orange Ave Ste 112a, Orlando, FL 32804-4639 | 2019-09-30 |
| 1558912006 | Ork Medical | Family Medicine | 2441 South Hiawassee Road, Orlando, FL 32835 | 2019-09-26 |
| 1649820267 | Florida Advanced Primary, Urgent & Holistic Medicine LLC | Family Medicine | 8931 Heritage Bay Cir, Orlando, FL 32836-5026 | 2019-09-16 |
| 1023664968 | Vera Lee Ahmad | Family Medicine | 18731 Sabal St, Orlando, FL 32833-5268 | 2019-08-15 |
| 1457912081 | Adventist Health System/sunbelt, Inc. | Family Medicine | 9637 Lake Nona Village Pl, Orlando, FL 32827-7319 | 2019-06-25 |
| 1639737273 | Adedeji A Onitiri | Family Medicine | 11750 E Colonial Dr Ste 100, Orlando, FL 32817-4656 | 2019-05-29 |
| 1962068783 | Health & Wellness Place | Family Medicine | 7363 W Colonial Dr, Orlando, FL 32818-6507 | 2019-05-16 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.