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NPI Code Detail

MEDICARE: ERICA DANIELLE SMITH OTR/L

MEDICARE: ERICA DANIELLE SMITH OTR/L
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
1225X00000XOccupational Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336657097
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA DANIELLE SMITH OTR/L
Provider Business Mailing Address
First Line : 3844 BEN STOUTAMIRE RD
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32310-9389
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6135 WILLIAMS RD
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32311-9107
Country : US
Telephone Number : 850-294-9716
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2018
Last Update Date : 06/16/2018

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