Individual
MRS. PAMELA YVETTA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4214 CYPRESS GLADES LN, ORLANDO, FL 32824-7417
(407) 312-4779
Mailing address
4214 CYPRESS GLADES LN, ORLANDO, FL 32824-7417
(407) 312-4779
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
FL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
372600000X
Adult Companion
—
FL
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103749600
—
FL
Enumeration date
11/18/2020
Last updated
09/10/2021
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