# JACQUELINE E. SMITH MD. PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891046199
- **Authorized official:** DR. JACQUELINE ELIZABETH SMITH M.D (OWNER)
- **Authorized official phone:** (954) 321-9555

## Contact information

- **Practice address:** 4101 NW 4TH ST, SUITE 409, PLANTATION, FL 33317-2850
- **Practice address phone:** (954) 321-9555
- **Practice address fax:** (954) 321-9557
- **Mailing address:** 4101 NW 4TH ST, SUITE 409, PLANTATION, FL 33317-2850
- **Mailing address phone:** (954) 321-9555
- **Mailing address fax:** (954) 321-9557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 71500 | FL | Yes |

## Other

- **Enumeration date:** 09/26/2012
- **Last updated:** 09/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 251684500 | — | FL |