Provider Demographics
NPI:1417988288
Name:SMITH, MICHEL M (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHEL
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6766 W SUNRISE BLVD
Mailing Address - Street 2:101
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313
Mailing Address - Country:US
Mailing Address - Phone:954-584-2900
Mailing Address - Fax:954-584-0025
Practice Address - Street 1:6766 W SUNRISE BLVD
Practice Address - Street 2:101
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313
Practice Address - Country:US
Practice Address - Phone:954-584-2900
Practice Address - Fax:954-584-0025
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2753132363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304235900Medicaid