Provider Demographics
NPI:1568251742
Name:SMYTHE, TASHANA M (PMHNP-BC)
Entity type:Individual
Prefix:MISS
First Name:TASHANA
Middle Name:M
Last Name:SMYTHE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 RIVERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6004
Mailing Address - Country:US
Mailing Address - Phone:754-779-5385
Mailing Address - Fax:
Practice Address - Street 1:3000 CORAL HILLS DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4108
Practice Address - Country:US
Practice Address - Phone:305-400-2291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039229363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health