Individual
EBONI SHAREE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13000 TANJA KING BLVD, ORLANDO, FL 32828-7374
(407) 273-7618
Mailing address
13808 DOVE WING CT, ORLANDO, FL 32828-7470
(910) 476-9419
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9525198
FL
Other
Enumeration date
12/24/2020
Last updated
12/24/2020
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