Individual
JATARRA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 DALTON CT, SATSUMA, FL 32189-2400
(904) 258-4645
Mailing address
100 DALTON CT, SATSUMA, FL 32189-2400
(904) 258-4645
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
237001
FL
253Z00000X
In Home Supportive Care Agency
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237001
HOMEMAKER COMPANION
FL
Enumeration date
05/24/2021
Last updated
07/31/2023
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