Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | ARNP904522 | FL |
NPI | 1053463588 |
---|---|
Provider Name | Juliet A Smith |
First Address | Doral, FL 33126-1828 |
Second Address | Doral, FL 33126-1828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 26/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
302099100 | (05) | FL |