Individual
DR. DAVID M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1223 GATEWAY DR, SUITE 1B, MELBOURNE, FL 32901-2607
(321) 312-3326
(321) 409-1786
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 312-3326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS0006610
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80805V
FL MEDICARE
FL
05
—
PENDING
—
FL
Enumeration date
11/14/2006
Last updated
03/19/2020
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