Doctor Name: | DR. CHRISTOPHER SMITH |
NPI Number: | 1790064863 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME116422 |
Business Practice Address: | 8297 Champions Gate Blvd Unit 5019 Champions Gate, FL - 338968387 |
Business Phone Number: | 4072781215 |
Business Fax Number: | |
Mailing Address: | 8297 Champions Gate Blvd, Unit 5019 CHAMPIONS GATE |
State: | FL |
Postal Code: | 338968387 |
Phone Number: | 3472577788 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2011 |
NPI Last Update Date: | 02/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME116422 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |