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Individual

CHARLES LEE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3600 RED RD STE 501, MIRAMAR, FL 33025
(954) 947-3290
(866) 572-2146
Mailing address
3600 RED RD STE 501, MIRAMAR, FL 33025-6015
(954) 947-3290
(866) 572-2146

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
OS15367
FL
208D00000X
General Practice Physician
832
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
832
STATE LICENSE
WV
01
OS15367
1841419058
FL
Enumeration date
04/25/2007
Last updated
01/19/2026
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