MEDICARE: NICOLE FRANCINE 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	235Z00000X	Speech-Language Pathologist	SA8055	FL

General Provider Information

NPI Number	:	1144847807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE FRANCINE SMITH

Provider Business Mailing Address
First Line	:	1643 VICTORIA POINTE CIR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-1311
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1643 VICTORIA POINTE CIR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-1311
Country	:	US
Telephone Number	:	954-254-3183
Fax Number	:

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

Provider Enumeration Date	:	06/29/2020
Last Update Date	:	06/29/2020

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Directions to “ NICOLE FRANCINE SMITH ” Practice Location

Language	Start Address	Practice Location

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