Provider Demographics
NPI:1427306745
Name:SMITH, SHARLENE HOPE (ARNP)
Entity type:Individual
Prefix:
First Name:SHARLENE
Middle Name:HOPE
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1206
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-1206
Mailing Address - Country:US
Mailing Address - Phone:352-589-8111
Mailing Address - Fax:352-589-8495
Practice Address - Street 1:4880 N HIGHWAY 19A
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-2018
Practice Address - Country:US
Practice Address - Phone:352-589-8111
Practice Address - Fax:352-589-8495
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9190118363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics