Individual
NIKEDA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
720 W OAK ST STE 303, KISSIMMEE, FL 34741-4992
(407) 520-3947
Mailing address
720 W OAK ST STE 303, KISSIMMEE, FL 34741-4992
(407) 520-3947
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9108550
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113073200
—
FL
01
—
V2050
MEDICARE - HFPS
FL
01
—
V2052
MEDICARE HFMG
FL
Enumeration date
02/14/2015
Last updated
12/05/2025
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