Basic Information
| Provider Information | |||||||||
| NPI: | 1508185976 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMRTIC | ||||||||
| FirstName: | JAMES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 936 WALNUT WOOD RD | ||||||||
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| City: | COCKEYSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210305410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109614610 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3599 UNIVERSITY BLVD S | ||||||||
| Address2: | BLDG 300 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043995550 | ||||||||
| FaxNumber: | 9043464334 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA9110342 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.