Provider Demographics
NPI:1871919522
Name:SMALT, JEFF (HAS)
Entity type:Individual
Prefix:MR
First Name:JEFF
Middle Name:
Last Name:SMALT
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 SW COLLEGE RD SUITE 1530
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474
Mailing Address - Country:US
Mailing Address - Phone:352-236-6700
Mailing Address - Fax:352-236-6701
Practice Address - Street 1:4414 SW COLLEGE RD
Practice Address - Street 2:1530
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4790
Practice Address - Country:US
Practice Address - Phone:352-236-6700
Practice Address - Fax:352-236-6701
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4859237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist