Individual
SUSAN SMITH
Active
Individual
SUSAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
ME70923
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME70923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250045100
—
FL
01
—
300067508
RR MEDICARE
FL
01
—
31502
BCBS OF FLORIDA
FL
Enumeration date
07/08/2005
Last updated
08/22/2016
Update your record
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