Provider Demographics
NPI:1891419982
Name:SMITH, ZAREJA T
Entity Type:Individual
Prefix:
First Name:ZAREJA
Middle Name:T
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3123 JUSTINE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-2309
Mailing Address - Country:US
Mailing Address - Phone:863-289-6813
Mailing Address - Fax:
Practice Address - Street 1:3123 JUSTINE AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2309
Practice Address - Country:US
Practice Address - Phone:863-289-6813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health