Dajan Tyrone Smith

Primary specialty

DriverTaxonomy code 172A00000X

License

S530178802140 Issued in FL

Practice address

8714 Sandy Plains Dr
Riverview, FL 33578-8615

Phone

(813) 777-4453

NPI assigned

Aug 22, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1063131373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8714 SANDY PLAINS DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335788615",
            "telephone_number": "813-777-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8714 SANDY PLAINS DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335788615",
            "telephone_number": "813-777-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAJAN",
        "middle_name": "TYRONE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "FL",
            "license": "524680",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "FL",
            "license": "S530178802140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda J Smith, OTA
• Caprice Smith, LCSW
• Chelsa Regail Smith, PT
• Cheyanne Smith, APRN
• Colette Rachelle Smith
• Jermia M Smith, LMHC MH16498
• Julie Smith
• Lena Smith
• Makala Smith
• Melissa Smith, PHARMD, CPH

• Driver in Riverview, FL
• Providers in Riverview, FL by specialty
• Driver in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.