MEDICARE: MIKIA SMITH MEDICAL SUPPLY

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1568258192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIKIA SMITH MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	427 34TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-4821
Country	:	US
Telephone Number	:	813-686-5245
Fax Number	:	813-692-4379

Provider Business Practice Location Address
First Line	:	427 34TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-4821
Country	:	US
Telephone Number	:	813-686-5245
Fax Number	:	813-692-4379

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MIKIA SMITH
Credential	:
Telephone Number	:	813-686-5245

Provider Enumeration Date	:	04/18/2025
Last Update Date	:	04/18/2025

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