Individual
RONALD SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12550 NEW BRITTANY BLVD STE 100, FORT MYERS, FL 33907-3655
(239) 343-9180
(239) 343-9188
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9180
(239) 346-9188
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
009083
GA
2084P0800X
Psychiatry Physician
Primary
OS18519
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114147000
—
FL
01
—
88309
MEDICAL LICENSE
GA
Enumeration date
05/22/2017
Last updated
07/29/2022
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