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General NPI Number Information
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NPI Number | 1841172053
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Entity Type | Individual
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Provider Name | MRS. ROBERTA A SMALLWOOD-NAZARIO
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Gender | Female
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 2202 N WEST SHORE BLVD STE 200
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City | TAMPA
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State | FL
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Zip | 33607-5749
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Country | US
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Telephone | 877-418-2978
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Fax |
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Provider Business Mailing Address
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Address Line | 14032 CITRUS POINTE DR
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City | TAMPA
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State | FL
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Zip | 33625-3155
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Country | US
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Telephone | 813-325-8227
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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-25-408063
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License Number State | FL
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