Healthcare Provider Details

I. General information

NPI: 1083641831
Provider Name (Legal Business Name): JENNIFER M. SMRTKA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 FAU BLVD SUITE 305
BOCA RATON FL
33431-6437
US

IV. Provider business mailing address

3848 FAU BLVD SUITE 305
BOCA RATON FL
33431-6437
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-2279
  • Fax: 305-243-8108
Mailing address:
  • Phone: 305-243-2279
  • Fax: 305-243-8108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberF303724-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberARNP9289105
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9289105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: