Individual
HENRY E SMOAK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
206 2ND ST E, BRADENTON, FL 34208-1042
(941) 746-5111
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
45395
CO
207P00000X
Emergency Medicine Physician
Primary
ME36892
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039499800
—
FL
05
—
55205887
—
CO
Enumeration date
06/15/2006
Last updated
10/07/2008
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