Individual provider Active NPI

Sharlene Hope Smith, ARNP

  • Pediatric Nurse Practitioner
  • Mount Dora, FL
National Provider Identifier
1427306745
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9190118 Issued in FL
Practice address
4880 N Highway 19a
Suite 200
Mount Dora, FL 32757-2018
Phone
(352) 589-8111
Fax
(352) 589-8495
NPI assigned
Aug 16, 2012
Last updated
Aug 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9190118 FL Primary

Addresses

Primary practice location

4880 N Highway 19a
Suite 200
Mount Dora, FL 32757-2018

Mailing address

PO Box 1206
Tavares, FL 32778-1206
Phone (352) 589-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221117000748 FL Practitioner - Nurse Practitioner 9830567122 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9190118FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Evening Pediatrics, Inc CurrentSince Oct 1, 2022 Accepting new patients
Lake Pediatrics P. a. PastSince Jul 8, 2020 Accepting new patients

Locations

2115 Central Ave
St Petersburg, FL 33713
Phone (727) 526-9135

4040 49th St N
St Petersburg, FL 33709
Phone (727) 526-6483

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1427306745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1206",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327781206",
            "telephone_number": "352-589-8111",
            "fax_number": "352-589-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 N HIGHWAY 19A",
            "address_2": "SUITE 200",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572018",
            "telephone_number": "352-589-8111",
            "fax_number": "352-589-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHARLENE",
        "middle_name": "HOPE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9190118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.