Provider Demographics
NPI:1417842444
Name:SMITH, PATRICIA LOUISE (RN, ATP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOUISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E TRADE WINDS RD
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-3521
Mailing Address - Country:US
Mailing Address - Phone:407-252-8788
Mailing Address - Fax:407-695-1148
Practice Address - Street 1:120 E TRADE WINDS RD
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-3521
Practice Address - Country:US
Practice Address - Phone:407-252-8788
Practice Address - Fax:407-695-1148
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6335225CA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner