Organization
AARON J SMITH & SOPHIA KIBUISMITH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON J SMITH (MANAGER)
(650) 440-0022
Entity
Organization
Contact information
Practice address
4811 5TH AVE S, ST PETERSBURG, FL 33711-1421
(650) 440-0022
Mailing address
4811 5TH AVE S, ST PETERSBURG, FL 33711-1421
(650) 440-0022
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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