Healthcare Provider Details

I. General information

NPI: 1356202071
Provider Name (Legal Business Name): SSMITH, APRN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1353 N COURTENAY PKWY STE L
MERRITT ISLAND FL
32953-4463
US

IV. Provider business mailing address

PO BOX 320041
COCOA BEACH FL
32932-0041
US

V. Phone/Fax

Practice location:
  • Phone: 727-265-0706
  • Fax: 321-616-8129
Mailing address:
  • Phone: 727-265-0706
  • Fax: 321-616-8129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE SMITH
Title or Position: NP
Credential:
Phone: 727-265-0706