Provider Demographics
NPI:1942069323
Name:SMOLJAN, LINDSAY RAE (FHP, HC)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:RAE
Last Name:SMOLJAN
Suffix:
Gender:F
Credentials:FHP, HC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 NE 2ND AVE APT 906
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5422
Mailing Address - Country:US
Mailing Address - Phone:708-945-4501
Mailing Address - Fax:
Practice Address - Street 1:3000 NE 2ND AVE APT 906
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5422
Practice Address - Country:US
Practice Address - Phone:708-945-4501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach