MEDICARE: MS. ALZORA WILLIAMS SMITH ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	ARNP462182	FL

General Provider Information

NPI Number	:	1073604823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALZORA WILLIAMS SMITH ARNP

Provider Business Mailing Address
First Line	:	3403 SUNNYSIDE DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32305-6969
Country	:	US
Telephone Number	:	850-877-0218
Fax Number	:

Provider Business Practice Location Address
First Line	:	3403 SUNNYSIDE DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32305-6969
Country	:	US
Telephone Number	:	850-877-0218
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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