Smith, Jarvis Cornielus

Smith, Jarvis Cornielus is an individual health care provider with primary practice located at 1002 N Semoran Blvd , Orlando FL 32807-3531. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Smith, Jarvis Cornielus can be contacted via phone (407) 275-8939.

Contact Information

Primary practice address
1002 N Semoran Blvd Orlando FL 32807-3531
Phone: (407) 275-8939
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1710475710
LBN Legal business name Smith, Jarvis Cornielus
Credentials B.A., CAP, VBHC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2018
Last updated Apr 25th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710475710 NPPES
Florida MEDICAID 101YA0400X

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