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General NPI Number Information
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NPI Number | 1679420129
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Entity Type | Individual
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Provider Name | TATIANA SMITH RBT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 2475 PALM BAY RD NE STE 231
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City | PALM BAY
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State | FL
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Zip | 32905-3359
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Country | US
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Telephone | 321-914-4055
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Fax | 321-473-8829
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Provider Business Mailing Address
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Address Line | 1420 SAN FILIPPO DR SE
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City | PALM BAY
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State | FL
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Zip | 32909-5900
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Country | US
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Telephone | 321-503-5749
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-26-518048
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License Number State | FL
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