MEDICARE: JAMESLA H SMITH

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	376J00000X	Homemaker		FL
2	374U00000X	Home Health Aide		FL

General Provider Information

NPI Number	:	1104752609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMESLA H SMITH

Provider Business Mailing Address
First Line	:	1711 FRUITWOOD DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2679
Country	:	US
Telephone Number	:	863-458-5447
Fax Number	:

Provider Business Practice Location Address
First Line	:	1711 FRUITWOOD DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2679
Country	:	US
Telephone Number	:	863-458-5447
Fax Number	:

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

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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Directions to “ JAMESLA H SMITH ” Practice Location

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