MEDICARE: LATASHIA E SMITH CNA

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	253Z00000X	In Home Supportive Care Agency
2	343900000X	Non-emergency Medical Transport (VAN)
3	376K00000X	Nurse's Aide	424183	FL

General Provider Information

NPI Number	:	1366133936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATASHIA E SMITH CNA

Provider Business Mailing Address
First Line	:	805 MILLARD ST
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-7039
Country	:	US
Telephone Number	:	850-556-0838
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 MILLARD ST
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-7039
Country	:	US
Telephone Number	:	850-556-0838
Fax Number	:

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

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	05/16/2023

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Directions to “ LATASHIA E SMITH CNA” Practice Location

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