Organization
JACQUELINE E. SMITH MD. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE ELIZABETH SMITH M.D (OWNER)
(954) 321-9555
Entity
Organization
Contact information
Practice address
4101 NW 4TH ST, SUITE 409, PLANTATION, FL 33317-2850
(954) 321-9555
(954) 321-9557
Mailing address
4101 NW 4TH ST, SUITE 409, PLANTATION, FL 33317-2850
(954) 321-9555
(954) 321-9557
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
71500
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251684500
—
FL
Enumeration date
09/26/2012
Last updated
09/26/2012
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