Healthcare Provider Details

I. General information

NPI: 1619952934
Provider Name (Legal Business Name): JENNIFER L SMIGIERA P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MISECHOK

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PASADENA AVE N
ST PETERSBURG FL
33710-8330
US

IV. Provider business mailing address

PO BOX 40658
ST PETERSBURG FL
33743-0658
US

V. Phone/Fax

Practice location:
  • Phone: 727-381-2500
  • Fax: 727-343-8746
Mailing address:
  • Phone: 727-381-2500
  • Fax: 727-343-8746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9103594
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberPA9103594
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: