Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fallon Smith Hayes Banton

Individual provider Family Medicine Physician · NPI 1407343569

Fallon Smith Hayes Banton is a Family Practice in St Petersburg, Florida. Qualified in 2017, 9 years ago. Practices with Dedicated Senior Medical Center of Florida, LLC, a 56-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
9
Licensed in
FL
In the registry since
2018
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Practice location Address checks out

901 22nd Ave S
St Petersburg, FL 33705-2933
Phone: (727) 310-0925
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME165869 (FL)

Record details

NPI number1407343569
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 15, 2018
Last updated in NPPESDecember 12, 2023
Certification dateDecember 12, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Dedicated Senior Medical Center Of Florida, Llc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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