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General NPI Number Information
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NPI Number | 1356557243
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Entity Type | Individual
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Provider Name | TARA BROOKE SMITH ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 11505 FAIRCHILD GARDENS AVE SUITE 101
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2847
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Country | US
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Telephone | 561-493-8314
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Fax | 561-493-8316
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Provider Business Mailing Address
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Address Line | 4800 N FEDERAL HWY SUITE C101
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City | BOCA RATON
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State | FL
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Zip | 33431-5188
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Country | US
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Telephone | 561-886-0970
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Fax | 561-886-0980
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9204359
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License Number State | FL
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