Individual
JOHNNA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239-3509
(941) 917-1668
(941) 917-4232
Mailing address
PO BOX 4930, DEPT. 102, HOUSTON, TX 77210-4930
(941) 917-1668
(941) 917-4273
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2612242
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305410100
—
FL
Enumeration date
06/07/2006
Last updated
06/06/2012
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