Provider Demographics
NPI:1457378440
Name:SMALLING, PAULETTE M (ARNP)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:M
Last Name:SMALLING
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 1:10421 BUENOS AIRES ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4566
Mailing Address - Country:US
Mailing Address - Phone:954-801-6856
Mailing Address - Fax:
Practice Address - Street 1:9750 NW 33RD ST
Practice Address - Street 2:214
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4042
Practice Address - Country:US
Practice Address - Phone:954-510-8200
Practice Address - Fax:954-510-0474
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1102412363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP1102412OtherARNP