Provider Demographics
NPI:1356557243
Name:SMITH, TARA BROOKE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:BROOKE
Last Name:SMITH
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Gender:F
Credentials:ARNP
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Mailing Address - Street 1:4800 N FEDERAL HWY
Mailing Address - Street 2:SUITE C101
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5188
Mailing Address - Country:US
Mailing Address - Phone:561-886-0970
Mailing Address - Fax:561-886-0980
Practice Address - Street 1:11505 FAIRCHILD GARDENS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2847
Practice Address - Country:US
Practice Address - Phone:561-493-8314
Practice Address - Fax:561-493-8316
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2014-06-13
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9204359363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner