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NPI Code Detail

MEDICARE: SHANELLE SMITH NP

MEDICARE: SHANELLE SMITH NP
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
1363L00000XNurse PractitionerAPRN11044021FL
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11044021FL

General Provider Information

NPI Number : 1811843956
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANELLE SMITH NP
Provider Business Mailing Address
First Line : 400 SW 1ST AVE APT 403
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-3477
Country : US
Telephone Number : 305-797-9630
Fax Number :
Provider Business Practice Location Address
First Line : 2801 N STATE ROAD 7
Second Line :
City : MARGATE
State : FL
Zip : 33063-5727
Country : US
Telephone Number : 954-974-0400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

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