MEDICARE: IESHA 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	376K00000X	Nurse's Aide	CNA351155	FL
2	2279H0200X	Home Health Registered Respiratory Therapist	RT25051	FL

General Provider Information

NPI Number	:	1831845981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IESHA SMITH

Provider Business Mailing Address
First Line	:	PO BOX 693376
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33269-0376
Country	:	US
Telephone Number	:	786-585-0538
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777A DAVIE ROAD EXT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2515
Country	:	US
Telephone Number	:	305-927-1649
Fax Number	:

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

Provider Enumeration Date	:	02/28/2022
Last Update Date	:	09/15/2025

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Directions to “ IESHA SMITH ” Practice Location

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