Individual
DR. MATTHEW L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17011 STATE ROAD 50 STE 103, CLERMONT, FL 34711-8203
(310) 721-3793
Mailing address
17011 STATE ROAD 50 STE 103, CLERMONT, FL 34711-8203
(310) 721-3793
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
ME98015
FL
207Q00000X
Family Medicine Physician
ME98015
FL
208000000X
Pediatrics Physician
Primary
ME98015
FL
2080A0000X
Pediatric Adolescent Medicine Physician
ME98015
FL
208D00000X
General Practice Physician
ME98015
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277908100
—
FL
Enumeration date
10/28/2005
Last updated
04/26/2023
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