Ethan Smith, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS54808 Issued in FL

Practice address

3304 Bonita Beach Road
Bonita Springs, FL 31434

Phone

(239) 495-1700

NPI assigned

May 12, 2017

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Publix Super Markets Inc

  dba Publix Pharmacy #1449

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1619916525
  NPD (past)
• Publix Super Markets Inc

  dba Publix Pharmacy #2107

  • Community/Retail Pharmacy
  • Winter Haven, FL
  • NPI 1760356380
  NPD (past)

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1184151896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 BONITA BEACH ROAD",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "31434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 BONITA BEACH ROAD",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "31434",
            "telephone_number": "239-495-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ETHAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS54808",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033.0096258",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marvin M Sloin, DO
• David Michael Small, PHD
• Smile Dental PLLC
• Smiles by Critchfield (Serenity Smiles)
• Caroline Smith, FNP
• Kayla Janelle Smith, DC
• SN Early Intervention Services
• Erika Irena Sodeika
• Emily Christine Sola, MSOT/L
• Solaris Health & Wellness LLC

• Pharmacist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.