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Individual

DR. ALEXANDER J SMIRNOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
729 HWY 466, LADY LAKE, FL 32159
(352) 633-2164
(352) 205-8149
Mailing address
1576 BELLA CRUZ DR, PMB 413, THE VILLAGES, FL 32159-8969
(352) 633-2164
(352) 205-8149

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
00026429
AL
174400000X
Specialist
Primary
ME106236
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009984185
AL
Enumeration date
10/04/2006
Last updated
03/29/2014
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