Individual
KATRINA J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4215 EDGEWATER DR, ORLANDO, FL 32804-2206
(973) 826-8080
(888) 972-6480
Mailing address
PO BOX 4059, WAYNE, NJ 07474-4059
(973) 826-8080
(888) 972-6480
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9105946
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FB469U
QSS SCS PTAN
DC
Enumeration date
04/13/2011
Last updated
07/21/2022
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