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Organization
STATE MEDICAL GROUP INC
Active
Organization
STATE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SMITH JACKSON (MANAGER)
(520) 843-4567
Entity
Organization
Contact information
Practice address
635 CAMBRIDGE CT, LONGWOOD, FL 32750-3901
(520) 843-4567
Mailing address
635 CAMBRIDGE CT, LONGWOOD, FL 32750-3901
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
08/29/2026
Last updated
08/29/2026
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