Organization
MARK A SMITH MD,P.A.
Active
Other names
Coastal Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ANTHONY SMITH M.D. (PRESIDENT/OWNER)
(904) 997-2221
Entity
Organization
Contact information
Practice address
10095 BEACH BLVD STE 300, JACKSONVILLE, FL 32246-4775
(904) 997-2221
(904) 997-2297
Mailing address
10095 BEACH BLVD STE 300, JACKSONVILLE, FL 32246-4775
(904) 997-2221
(904) 997-2297
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
ME77870
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871558114
INDIVIDUAL PRACTITIONER
FL
Enumeration date
08/05/2006
Last updated
08/22/2020
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