Jacqueline E. Smith MD. PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

71500 Issued in FL

Legal business name

JACQUELINE E. SMITH MD. PA

Practice address

4101 NW 4TH St
Suite 409
Plantation, FL 33317-2850

Phone

(954) 321-9555

Fax

(954) 321-9557

NPI assigned

Sep 26, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline Elizabeth Smith, M.DNPI 1396709689

Title

Owner

Phone

(954) 321-9555

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• HealthSun Health Plans Network

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Elizabeth Smith, M.D.

  • Ophthalmology Physician
  • Plantation, FL
  • NPI 1396709689
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348617600000",
    "number": "1891046199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 NW 4TH ST",
            "address_2": "SUITE 409",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172850",
            "telephone_number": "954-321-9555",
            "fax_number": "954-321-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NW 4TH ST",
            "address_2": "SUITE 409",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172850",
            "telephone_number": "954-321-9555",
            "fax_number": "954-321-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE E. SMITH MD. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-321-9555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "71500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251684500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarence Jackson
• Beena Jacob, PA-C
• Jacobs Tender Loving Care Assisted Living Facility
• Stephen Jacobs, MD
• Philip Jacobson, MD
• Eva Mireille Jacques, ARNP
• Florise Jadotte
• Herltg-Debbie M Jadotte, ARNP
• Ashkan Jafarbay, MD
• Faraz Jaffer, M.D.

• Ophthalmology Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.