Individual
JEFFREY RICHARD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14 WEST GORE ST, ORLANDO, FL 32806
(321) 843-5001
(321) 843-5085
Mailing address
14 WEST GORE ST, ORLANDO, FL 32806
(321) 843-5001
(321) 843-5085
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0072971
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256468800
—
FL
01
—
46648
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/05/2006
Last updated
11/13/2012
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