Organization
ROBERT J. SMITH, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JOHN SMITH M.D. (OWNER/PHYSICIAN)
(407) 321-4200
Entity
Organization
Contact information
Practice address
2425 S PARK AVE, SANFORD, FL 32771-4419
(407) 321-4200
Mailing address
2425 S PARK AVE, SANFORD, FL 32771-4419
(407) 321-4200
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080104508
RR MEDICARE
FL
01
—
59034
BCBSFL
FL
Enumeration date
03/05/2015
Last updated
03/05/2015
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