MEDICARE: JARITZA SMITH ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9296636	FL
2	363L00000X	Nurse Practitioner	ARNP9296636	FL
3	363LF0000X	Family Nurse Practitioner	APRN9296636	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP9296636	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1013311109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARITZA SMITH ARNP

Provider Business Mailing Address
First Line	:	2675 WINKLER AVE FL 2
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9342
Country	:	US
Telephone Number	:	833-674-2500
Fax Number	:	239-599-4126

Provider Business Practice Location Address
First Line	:	15201 N CLEVELAND AVE STE 1010
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-2717
Country	:	US
Telephone Number	:	833-674-2500
Fax Number	:	239-599-4126

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2014
Last Update Date	:	10/14/2024

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Directions to “ JARITZA SMITH ARNP” Practice Location

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