Individual
GENQUETTA MICHELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDE CONTRACTOR
Contact information
Practice address
7938 CARRIAGE POINTE DR, GIBSONTON, FL 33534-3007
(727) 657-8044
Mailing address
PO BOX 418, SEFFNER, FL 33583-0418
(727) 657-8044
Taxonomy
Speciality
Code
Description
License number
State
2470A2800X
Assistant Health Information Record Technician
—
FL
2472R0900X
Renal Dialysis Technician
—
FL
372600000X
Adult Companion
131219
FL
3747P1801X
Personal Care Attendant
Primary
131219
FL
374U00000X
Home Health Aide
—
FL
376K00000X
Nurse's Aide
1311219
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131219
CERTIFIED NURSING ASSISTANT
FL
Enumeration date
01/26/2018
Last updated
01/26/2018
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