Provider Demographics
NPI:1710953450
Name:SMITH, JANET MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:MARIE
Other - Last Name:BULGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:601 BROOKER CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2962
Mailing Address - Country:US
Mailing Address - Phone:813-818-3226
Mailing Address - Fax:
Practice Address - Street 1:601 BROOKER CREEK BLVD
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-2962
Practice Address - Country:US
Practice Address - Phone:813-818-3226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3283302363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308368300Medicaid
FLQ28633Medicare UPIN
FLU3731ZMedicare ID - Type Unspecified