Healthcare Provider Details

I. General information

NPI: 1225316789
Provider Name (Legal Business Name): ADRIA M SMITH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2011
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR SUITE 487
OCOEE FL
34761-3400
US

IV. Provider business mailing address

10000 W COLONIAL DR SUITE 487
OCOEE FL
34761-3400
US

V. Phone/Fax

Practice location:
  • Phone: 407-296-1923
  • Fax: 407-445-5550
Mailing address:
  • Phone: 407-296-1923
  • Fax: 407-445-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 9209362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: