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Organization
RENALDAS ALGIRDAS SMIDTAS
Active
Organization
RENALDAS ALGIRDAS SMIDTAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENALDAS A SMIDTAS MD (OWNER)
(386) 792-0753
Entity
Organization
Contact information
Practice address
413 5TH AVE NW, JASPER, FL 32052-7800
(386) 792-0753
Mailing address
413 NW 5TH AVE, JASPER, FL 32052
(386) 792-0753
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0069486
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103986
AVMED
FL
01
—
110117134
RAILROAD MEDICARE
—
01
—
27984
BCBS
FL
05
—
378783400
—
FL
Enumeration date
03/19/2008
Last updated
06/30/2011
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