Provider Demographics
NPI:1003816216
Name:SMOAK, WILLIAM M III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:SMOAK
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 402808
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-0808
Mailing Address - Country:US
Mailing Address - Phone:305-695-0644
Mailing Address - Fax:305-672-9971
Practice Address - Street 1:400 W 41ST ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3516
Practice Address - Country:US
Practice Address - Phone:305-695-0644
Practice Address - Fax:305-672-9971
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 10143207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90932YOtherMEDICARE
FL036549100Medicaid
FL036549100Medicaid