Healthcare Provider Details

I. General information

NPI: 1659290401
Provider Name (Legal Business Name): MS. LAURYN-MAGGIE ARENEE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 DAVIS BLVD STE 100
TAMPA FL
33606-3468
US

IV. Provider business mailing address

17 DAVIS BLVD STE 100
TAMPA FL
33606-3468
US

V. Phone/Fax

Practice location:
  • Phone: 727-542-1908
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26816
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: