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General NPI Number Information
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NPI Number | 1447633599
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Entity Type | Organization
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Legal Business Name | TASHA SMITH
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 927 SUNRIDGE POINT DR
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City | SEFFNER
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State | FL
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Zip | 33584-5932
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Country | US
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Telephone | 718-634-1617
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Fax |
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Provider Business Mailing Address
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Address Line | 927 SUNRIDGE POINT DR
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City | SEFFNER
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State | FL
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Zip | 33584-5932
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Country | US
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Telephone | 718-634-1617
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Fax |
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Authorized Official
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Title or Position | R.N
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Name | MS. TASHA SMITH
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Credential | R.N
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Telephone | 718-634-1617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 928-1576
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License Number State | FL
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