Provider Demographics
NPI:1972625960
Name:SMITH, ELENA M (CPNP, DNP)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:CPNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 WINTER GARDEN VINELAND RD STE 207
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6098
Mailing Address - Country:US
Mailing Address - Phone:407-635-3280
Mailing Address - Fax:407-636-7853
Practice Address - Street 1:5151 WINTER GARDEN VINELAND RD STE 207
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6098
Practice Address - Country:US
Practice Address - Phone:407-635-3280
Practice Address - Fax:407-636-7853
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9180168363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics