| NPI | 1134084494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA JORDAN SMOTHERMAN Pmhnp 941-285-2702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-12-18 |
| Last Update Date | 2025-12-18 |