Provider Demographics
NPI:1467664284
Name:SMOYAK, JENNIFER ANN (MS, ATC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:SMOYAK
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 ARAGON AVE.
Mailing Address - Street 2:APT. 609
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:407-925-1452
Mailing Address - Fax:
Practice Address - Street 1:11200 SW 8TH ST.
Practice Address - Street 2:PHARMED ARENA RM 156G
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199
Practice Address - Country:US
Practice Address - Phone:305-348-0131
Practice Address - Fax:305-348-3673
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL18962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer