Provider Demographics
NPI:1013311109
Name:SMITH, JARITZA (ARNP)
Entity type:Individual
Prefix:
First Name:JARITZA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:833-674-2500
Mailing Address - Fax:239-599-4126
Practice Address - Street 1:15201 N CLEVELAND AVE STE 1010
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-2717
Practice Address - Country:US
Practice Address - Phone:833-674-2500
Practice Address - Fax:239-599-4126
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9296636163W00000X
FLARNP9296636363L00000X
FLAPRN9296636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9296636OtherMEDICAL LICENSE
FLARNP9296636OtherMEDICAL LICENSE