Provider Demographics
NPI:1952720351
Name:SMIKKER, STEPHANEE CHRISTINA (PA)
Entity Type:Individual
Prefix:
First Name:STEPHANEE
Middle Name:CHRISTINA
Last Name:SMIKKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:STEPHANEE
Other - Middle Name:CHRISTINA
Other - Last Name:STONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:400 N ASHLEY DR
Mailing Address - Street 2:SUITE 1625
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4300
Mailing Address - Country:US
Mailing Address - Phone:813-514-6387
Mailing Address - Fax:813-844-4972
Practice Address - Street 1:1 TAMPA GENERAL CIR
Practice Address - Street 2:SUITE A327
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-844-4434
Practice Address - Fax:813-844-4972
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9107883363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant