Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME34785 | FL |
Y | 208600000X | Surgeon | ME34785 | FL |
N | 2086S0129X | Vascular Surgeon | ME34785 | FL |
N | 208C00000X | Colorectal Surgeon | ME34785 | FL |
N | 208D00000X | General Practice Physician | ME34785 | FL |
NPI | 1073558300 |
---|---|
Provider Name | Steven Jay Smith |
First Address | Marathon, FL 33050-2329 |
Second Address | Marathon, FL 33050-2784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 03/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038196900 | (05) | FL |
44157 | BLUE CROSS BLUE SHIELD (01) | FL |
P00060772 | RAILROAD MEDICARE (01) | FL |