Healthcare Provider Details

I. General information

NPI: 1558072108
Provider Name (Legal Business Name): CAROLINE SMITH GHEE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE ALEXANDRA SMITH PA-C

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 19TH ST NW STE 420
WASHINGTON DC
20036-3606
US

IV. Provider business mailing address

4700 EXCHANGE CT STE 110
BOCA RATON FL
33431-4450
US

V. Phone/Fax

Practice location:
  • Phone: 202-955-6995
  • Fax: 202-955-3908
Mailing address:
  • Phone: 561-948-0291
  • Fax: 561-859-0429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1975
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA200002073
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: