Provider Demographics
NPI:1811343452
Name:TASHA SMITH
Entity type:Organization
Organization Name:TASHA SMITH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:LAVONNE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-270-8068
Mailing Address - Street 1:5686 ESTABROOK WOODS DR
Mailing Address - Street 2:APT 201
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6117
Mailing Address - Country:US
Mailing Address - Phone:321-662-2346
Mailing Address - Fax:407-270-8068
Practice Address - Street 1:5686 ESTABROOK WOODS DR
Practice Address - Street 2:APT 201
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-6117
Practice Address - Country:US
Practice Address - Phone:321-662-2346
Practice Address - Fax:407-270-8068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child