Organization
KATRINA JAHEN SMITH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATRINA JAHEN SMITH PA-C (PHYSICIAN ASSISTANT)
(813) 368-0683
Entity
Organization
Contact information
Practice address
21742 GARDEN WALK LOOP, LAND O LAKES, FL 34637-7610
(813) 368-0683
Mailing address
PO BOX 2101, LAND O LAKES, FL 34639-2101
(813) 368-0683
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9105946
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9105946
FLORIDA DEPARTMENT OF MEDICINE
FL
Enumeration date
07/31/2018
Last updated
07/31/2018
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