Healthcare Provider Details

I. General information

NPI: 1689989246
Provider Name (Legal Business Name): L'TANYA LEE SMITH RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 NE 202ND ST
MIAMI FL
33179-5158
US

IV. Provider business mailing address

1420 NE 202ND ST
MIAMI FL
33179-5158
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-7338
  • Fax:
Mailing address:
  • Phone: 305-651-7338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number9653
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: